liJIZiJOMPENDS 


Anatomy 


DR.  POTTE 


MORRIS'  ANATOMY. 

SECOND  EDITION- 
79 J  Illustrations^  of  which  2J4  are  Gjlored. 


MEBICAL    .SCMOOL 
UISMAmif 


eatise  by  Vari- 
.  Surgical  and 
Vestigial  and 
)RRis,  M.A.  and 
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ondon ;  Mem- 
lourt  of  Exam- 
jcond  Edition. 
;d  throughout, 
hich  are  Orig- 
Royal  Octavo. 
her,  net,  $7.00 

and  publishers 
The  text  has 
ten  ;  the  editor 
iionious  whole ; 
ed  in  the  first 
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and  excellence 
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ars. 


surgical  and  topo- 
1  is  presented  with 
:y  of  the  book  with 
ay  safely  be  recom- 


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For  the  student,  the  surgeon,  or  Iof~tKe  general   practitioner  who 
desires  to  review  his  anatomy,  Morris'  is  decidedly  the  book  to  buy." 

A  Descriptive  Circular  of  Morris'  ''Anatomy,''  with  Sample  Pages 
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H.  A.  STOCKWELL 

OPTOMETRIST 

BERKELEY,  CAUF. 


COMPEND  OF  ANATOMY 


POTTER 


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PHILADELPHIA. 


?  QUIZ-CO  MPENDS?    No.  1 


A  COMPEND 


HUMAN   ANATOMY 

INCLUDING   THE 

ANATOMY  OF  THE  VISCERA 

SAMUEL  O.  L.  POTTER,  M.A.,  M.D..  M.R.C.P.  (Lond.) 

PROFESSOR    OF   THE    PRINCIPLES   AND    PRACTICE    OF     MEDICINE    AND    CLINICAL    MEDICINE   IN 
THE   COLLEGE   OF    PHYSICIANS    AND    SURGEONS   OF    SAN   FRANCISCO;    MEDICAL   SUPERIN- 
TENDENT OF  ST.  mark's  hospital;    author  OF   "  H.\NDBOOK  OF  MATERIA   MEDICA, 
PHARMACY,     AND    THERAPEUTICS,"     "  QUIZ-COMPEND     OF     MATERIA      MEDICA," 
"  AN      INDEX   OF     COMPARATIVE     THERAPEUTICS,"    AND     "  SPEECH     AND 
ITS     DEFECTS";      BRIGADE     SURGEON     U.     S.     VOL, 

SIXTH  EDITION,  REVISE!^  AND  ENLARGED 

WITH    117    WOOD    ENGRAVINGS;   ALSO    AN    APPENDIX    CONTAINING 

NUMEROUS  TABLES  AND  SIXTEEN  LITHOGRAPHIC  PLATES 

OF  THE   NERVES  AND  ARTERIES 

PHILADELPHIA 
P.    BLAKISTOI^'S   SON   &   CO. 

No.    IOI2  Walnut  Street 
1902 


TO  THE  MEMORY 

OF 

AN  AMERICAN  SURGEON   AND  ANATOMIST. 

WHOSE   FAME   IS   ACKNOWLEDGED  THROUGHOUT 
THB  WHOLE   CIVILIZED  WORLD, 

JOSEPH   PANCOAST, 

FORMERLY   PROFESSOR   OF   ANATOMY   IN  JEFFERSON    MEDICAL   COLLEGE: 
AND  TO 

WILLIAM   H.    PANCOAST, 

LATB   PROFESSOR   OF  ANATOMY   IN  JEFFERSON   MEDICAL   COLLEGE, 

THE  TALENTED   AND   COURTEOUS 

REPRESENTATIVE    OF    A    GREAT    NAME, 

JTHOSE   ENTHUSIASTIC   TEACHINGS,   NO    LESS  THAN   HIS   GENIAL   SALUTATIONS, 

ARE  TREASURED   IN   LOVING  REMEMBRANCE  BY   EVERY   STUDENT 

WHO   HAS   HEARD   HIM, 

THIS  COMPEND  OF  HUMAN  ANATOMY 

IS 

AFFECTIONATELY  DEDICATED, 

BY   ONB   OF   HIS 

"STAR  ANATOMICAL  MEN.' 


Copyright,  i8qo,  by  P.  Blakiston,  Son  &'  Co. 


PREFACE 


THIS  book  contains  the  complete  text  of  my  two  Compends 
of  Anatomy,  namely — the  ''Human  Anatomy,"  and  the 
''Visceral  Anatomy,"  heretofore  published  as  separate  volumes 
in  this  series  of  students*  manuals.  The  marked  favor  with 
which  these  Compends  were  first  received,  some  three  and  a 
half  years  ago,  has  since  been  continuously  extended  to  them  by 
teachers  and  students,  both  in  America  and  in  England.  This 
has  been  manifested  by  the  sale  of  a  new  and  large  edition  every 
year,  and  has  been  extremely  gratifying  to  the  author.  Upon 
the  exhaustion  of  the  third  edition,  the  publishers  resolved  to 
acknowledge  the  universal  appreciation  shown  these  books,  by 
incorporating  the  two  in  one  volume ;  making  this,  the  first  of 
the  now  well-known  "  Quiz-Compends,"  a  complete  quiz-book 
on  Human  Anatomy.  In  carrying  out  this  generous  resolution, 
the  original  matter  has  not  been  curtailed  anywhere ;  but,  on 
the  contrary,  much  new  matter  has  been  introduced  wherever 
greater  detail  seemed  to  be  desirable,  and  the  number  of  the 
illustrations  has  been  increased  by  eighteen  new  cuts. 

Originally  designed  for  the  use  of  the  medical  student,  in  pre- 
paring for  the  exercises  of  the  quiz-room  and  for  his  final  exam- 
ination, the  text  is  confined  to  the  essentials  of  each  structure 
treated  of,  which  are  arranged  in  such  a  manner  as  to  facilitate 
their  rapid  acquirement.  All  superfluities  of  description  have 
been  studiously  avoided,  and  only  such  matter  inserted  as  should 
be  thoroughly  known  in  order  to  pass  a  rigid  examination  on 
any  organ  or  structure  of  the  human  body.  The  descriptions 
will  be  found  to  closely  follow  Gray,  though  Quain  and  other 
recognized  authorities  have  been  freely  consulted  during  the 
preparation  of  the  text.     For  many  of  the  special  arrangements 


85937 


Vi  PREFACE. 

the  author  is  indebted  to  the  lectures  of  Professor  W.  H.  Pan^ 
coast,  late  of  Jefferson  Medical  College,  and  to  the  quizzes  of  Dr. 
Henry  Morris,  formerly  assistant  to  the  Chair  of  Anatomy  in  the 
same  school. 

While  striving  to  carry  out  the  object  of  this  series  in  furnish- 
ing the  medical  student  with  a  condensed  Manual  of  Anatomy, 
the  author  has  endeavored,  from  a  strong  appreciation  of  the 
importance  of  the  subject,  to  make  this  volume  deserving  of  first 
rank  among  its  kind ;  and  believing  that  a  judicious  condensation, 
which  does  not  slight  the  essential  features  of  the  subjects  treated^ 
cannot  fail  to  be  of  benefit  in  any  department  of  science,  he 
again  commits  his  Compend  to  the  teachers  and  students  of 
Anatomy,  in  the  hope  that  it  may  continue  to  be  found  worthy 
of  a  place  alongside  the  more  exhaustive  and  exhausting  text- 
books. 

January,  1887. 


Preface  to  the  Fifth  Edition. 

Another  edition  of  this  Compend  having  been  exhausted,  the 
publishers  have  requested  me  to  improve  the  book  in  any  way 
which  will  keep  it  in  the  front  rank  among  works  of  its  class. 
I  have  therefore  added  an  Appendix  of  forty-three  pages,  con- 
taining an  original  and  complete  set  of  Tables  and  Plates  of  the 
Arteries,  the  Cranial  and  Spinal  Nerves  and  Plexuses,  and  the 
Sympathetic  Nervous  System.  These  have  been  prepared 
especially  for  this  book,  and  will,  I  think,  prove  of  very  great 
value  to  the  student  in  college,  and  the  physician  in  practice, 
who  desires  a  comprehensive  view  of  these  complicated  parts  of 
the  human  organism. 

Sam'l  O.  L.  Potter. 
Cooper  Medical  College, 

San  Francisco y  July,  1 890. 


TABLE  OF  CONTENTS. 


ANATOMY. 

PAGE 

OSTEOLOGY 9 

BONES  OF  THE  HEAD ^. 12 

The  Okbits 29 

The  Foss^ 31 

The  Sutures  and  Fontanelles 33 

The  Wormian  Bones 33 

The  Hyoid  Bone 33 

Table  of  the  Foramina  at  the  base  of  the  Skull 34 

BONES  OF  THE  TRUNK  36 

The  Vertebral  Column 36 

The  Thorax 38 

The  Sternum 38 

The  Ribs 38 

THE  PELVIS 40 

BONES  OF  THE  UPPER  EXTREMITY 43 

The  Shoulder 43 

The  Arm 45 

The  Forearm 47 

The  Hand 48 

BONES  OF  THE  LOWER  EXTREMITY 50 

The  Thigh 50 

The  Leg ..  ..  51 

The  Foot 53 

ARTICULATIONS 55 

MUSCLES  AND  FASCI-ffi  OF— 

The  Head 68 

The  Ear 71 

The  Neck 71 

The  Larynx  and  Epiglottis 75 

The  Back 76 

The  Abdomen 80 

The  Thorax 82 

The  Perineum 83 

vii 


WU  CONTENTS. 

PAGB 

The  Shoulder  and  Arm ^5 

The  Forearm 87 

The  Hand 9° 

The  Hip  and  Thigh •    9^ 

The  Leg 95 

The  Foot 97 

rHE  HEART 99 

ARTERIES 102 

THE  CIRCLE  OF  WILLIS 106 

ARTERIAL  ANASTOMOSES ,. "4 

VEINS "5 

ABSORBENTS "9 

NERVOUS  SYSTEM 120 

THE  BRAIN "o 

THE  SPINAL  CORD 129 

THE  CRANIAL  NERVES 129 

THE  SPINAL  NERVES 133 

THE  SYMPATHETIC  NERVE 136 

VISCERAL   ANATOMY. 

DIGESTIVE  ORGANS I4» 

ALIMENTARY  CANAL ". 141 

TEETH 141 

Structure 142 

Development 143 

MOUTH 144 

Palate 144 

Tonsils 144 

Salivary  Glands 145 

Tongue 145 

PHARYNX i4fi 

CESOPHAGUS 147 

STOMACH 148 

SMALL  INTESTINE 150 

Duodenum 150 

Jejunum. 150 

Ileum 150 

LARGE  INTESTINE 151 

CiBCUM 151 

Appendix  Vermiformis xS* 

Colon 15a 


CONTENTS.  IX 

PAGH 

Rectum 152 

LIVER 153 

Ligaments 154 

Fissures 154 

Lobes 154 

Vessels 155 

Capsule  of  Glisson 156 

Gall-bladder 156 

PANCREAS 157 

DUCTLESS  GLANDS 158 

Spleen 158 

Thyroid  Gland 159 

Thymus  Gland .* 160 

Supra-renal  Capsules 160 

ABDOMINAL  CAVITY 161 

Boundaries 161 

Openings 162 

Regions 162 

PERITONEUM 163 

Foramen  of  Winslow 163 

Omenta 164 

Mesenteries 164 

ORGANS  OF  VOICE  AND   RESPIRATION 165 

LARYNX 165 

TRACHEA  AND  BRONCHI 170 

LUNGS 171 

PLEURA 174 

Mediastinum 174 

URINARY  ORGANS 175 

KIDNEYS 175 

URETERS 177 

BLADDER ^ 178 

Male  Urethra 179 

Female  Urethra iBi 

MALE  GENERATIVE  ORGANS 181 

PROSTATE  GLAND 181 

COWPER'S  GLANDS i8x 

PENIS 182 

TESTES  AND  APPENDAGES 183 

Descent  of  the  Testes i8< 


X  CONTENTS. 

PAGB 

FEMALE  ORGANS  OF  GENERATION 187 

VULVA 187 

VAGINA 188 

UTERUS  AND  APPENDAGES 188 

Fallopian  Tubes 190 

Ovaries - 190 

Parovarium 192 

MAMMiE 192 

ORGANS  OF  SENSE 193 

SKIN  AND  ITS  APPENDAGES 193 

TONGUE 195 

NOSE 195 

Schneideria'n  Membrane 19S 

EYE 197 

Sclerotic  and  Cornea 19S 

Uveal  Tract 200 

Retina 202 

Humors 204 

Vessels  and  Nerves  of  the  Eye 207 

APPENPAGES  of  the   EyE  209 

EAR 212 

External  Ear 213 

Membrana  Tympani.. 214 

Tympanum 216 

Eustachian  Tube 219 

Internal  Ear 219 

HERNIA 226 

INGUINAL  HERNIA 226 

Coverings 227 

FEMORAL  HERNIA 228 

Coverings 229 

PERINEUM 230 

MALE  PERINEUM 230 

Lithotomy 231 

FEMALE  PERINEUM 232 

ILPPENDIX » 835 

THE  ARTERIAL  SYSTEM,  Tables  and  Plates... 236 

THE  NERVOUS  SYSTEM,  Tables  and  Plates 951 

\NDEX 277 


LIST  OF  ILLUSTRATIONS. 


FlG.  PAGH 

Base  of  the  Brain xii 

1.  The  Temporal  Bone,  external  view,  15 

2.  The  Temporal  Bone,  internal  view,  16 

3.  The  Sphenoid  Bone,  upper  surface,  18 

4.  The  Sphenoid  Bone,  lower  surface..  19 

5.  The  Ethmoid  Bone 21 

6.  The  Superior  Maxillary  Bone 22 

7.  The  Malar  Bone 24 

8.  The  Palate  Bone 25 

9.  The  Inferior  Turbinated  Bone 26 

10.  The  Vomer 26 

11.  The  Inferior  Maxillaiy  Bone 27 

12.  The  Cavity  of  the  Oibit 29 

13.  The  Nasal  Fossae - 31 

14.  The  Base  of  the  Sicull 34 

15.  A  Vertebra 36 

16.  The  Sternum 38 

17.  Ribs...  39 

18.  The  First  Rib 39 

19.  The  Pelvis 40 

20.  The  Sacrum 41 

21.  The  Coccyx 41 

22.  The  Innominate  Bone 42 

23.  The  Humerus 46 

24.  The  Radius  and  Ulna 47 

25.  The  Bones  of  the  Carpus 48 

26.  The  Femur 50 

27.  The  Tibia  and    Fibula 52 

28.  Bones  of  the  Tarsus  and  Foot 53 

29.  The  Occipito-atloid  Articulation,  etc.  56 

30.  The    Temporo-maxillary   Articula- 

tion,   57 

31.  The  Costo-vertebral  Articulations...  58 

32.  The Sacro-ischiatic  Articulation,  etc.  59 

33.  The  Shoulder-joint,  etc 60 

34.  The  Elbow-joint. ..  61 

35.  The  Knee-joint,  posteriorly 64 

36.  The  Knee-joint,  anteriorly 64 

37.  Muscles  of  the  Face  and  Forehead..  69 

38.  Muscles  of  the  Neck 72 

39.  Muscles  ot  the  Back 77 

40.  Muscles  ot  the  Back,  deep  layers....  79 

41.  Muscles  of  the  Chest  and  Abdomen,  81 

42.  The  Diaphragm 83 

43.  Muscles  of  the   Perineum 84 

44.  Muscles  of  the  Arm 86 

45.  Muscles  of  the    Fore -arm  and  Hand 


.(0, 


46.  Muscles  of  the   Fore-arm  and  Hand 

(2) 89 

47.  Muscles  of  the  Thigh,  anteriorly 92 

48.  Muscles  of  the  Thigh,  posteriorly,...  93 
^9.  Muscles  of  the  Hip  joint 94 

50.  Muscles  of  the  Leg,  anteriorly 96       107 

51.  Muscles  of  the    Leg,  posteriorly 97       108. 

52.  Muscles  of   the  Foot 98       109. 

53.  The  Heart 101 

54.  The  Aorta 103 

55.  Arteries  of  the  Face  and  Head 104        112, 

56.  The  Right    Internal    Maxillary  Ar  113. 

tery 104        114. 

57    The  Subclavian  Artery 106        115. 

58.  The  Abdominal  Aorta IC9        116, 

Sixteen  Lithographic  Plates 

xi 


PAGB 

The  Femoral  Artery iia 

The    Venae     Cavae    and    Azygos 

Veins 117 

The  Optic  Nerves  and  Tract,  etc.  130 

The  Fifth  Cranial  Nerve 130 

The    Sacral    Plexus,  and    its 

branches 135 

The  Three  Petrosal  Nerves 138 

A  Tooth 142 

The  Salivary  Glands 144 

The  Tongue  and  Fauces 145 

The  Muscles  of  the  Pharynx 147 

The  Stomach    148 

Arteries  of  the  Stomach,  Pancreas, 

etc 149 

The  Duodenum 150 

The  Colon  and  Rectum 152 

The  Liver 153 

Structure  of  the  Liver  (vessels) 155 

Structure  of  the  Liver  (cells) 156 

The  Pancreas 157 

The  Spleen 158 

Regions  of  the  Abdomen 162 

The  Peritoneum 164 

The  Thyroid  Cartilage i66 

The  Cricoid  Cartilage 166 

The  Arytenoid  Cartilages 166 

Muscles  of  the  Larynx 169 

The  Lungs,  Heart,  etc 172 

Lobules  and  Alveoli  of  the  Lung....  173 

The  Kidney 175 

A  Malpighian  Tuft 176 

The  Bladder 178 

The  Male  Urethra,  etc 180 

Section  of  the  Penis 182 

Section  of  the  Testicle  and  Scro- 
tum   184 

Ducts  of  the  Testicle  and  Epididy- 
mis   185 

The  Vulva 187 

The  Uterus  and  its  Appendages 189 

The  Mammae , 192 

The  Skin  and  its  Appendages 193 

The  Nose 196 

The  Eye 198 

The  Iris 201 

The  Retina 203 

The  Crystalline  Lens 205 

The  Muscles  of  the  Eyeball 206 

Appendages  of  the  Eye 209 

Structure  of  the  Eyelids 210 

The  Lachrymal  Gland 212 

The  Membrana  Tympani 215 

The  Tympanum 217 

The  Internal  Ear 220 

The  Cochlea 221 

The  Membranous  Labyrinth 222 

The  Membranous  Cochlea 223 

Rods  of  Corti 224 

Auditory  Cells 224 

Poupart's  Ligament 227 

Femoral  Hernia 228 

The  Male  Perineum 23a 

,  in  Appendix. 


THE  BASE  OF  THE  BRAIN. 


I.  Olfactory  Bulb.  2.  Second,  or  Optic  Nerves.  3.  Anterior  Perforated  Space.  4. 
Optic  Tract.  5.  Crus  Cerebri.  6.  3d  Nerve.  7.  4th  Nerve.  8.  5th  Nerve.  9.  6th  Nerve. 
10.  Pyramid.  11.  Olivary  Body.  12.  Vertebral  Artery.  13.  Anterior  Spinal  Artery.  14. 
Anterior  Cerebral  Artery.  15.  Lamina  Cinerea.  16.  Middle  Cerebral  Artery.  17.  Tuber 
Cinereum.  18.  Corpora  Albicantia.  19.  Middle  Perforated  Space.  20.  Posterior  Cerebral 
Artery.  21.  Superior  Cerebral  Artery.  22.  Pons  Varolii.  23.  Inferior  Cerebellar  Artery. 
94.  7th  and  8th  Nerves.     25.  9th,  loth  and  nth  Nerves.     26.  12th  Nerve.     27.  Cerebellum. 


COMPEND  OF  ANATOMY. 


Define  the  term  Anatomy.  Derived  from  the  Greek  dva  ana,  through,  and 
tifiveiv  iemnein,  to  cut,  it  strictly  means  dissection,  but  is  technically  applied  to 
that  science  which  treats  of  the  structure  of  organized  bodies. 

What  are  the  divisions  of  Descriptive  Human  Anatomy  ?  They  are, — 
Osteology,  the  anatomy  of  the  bones;  Syndesmology,  of  the  joints;  Myology, 
of  the  muscles ;  Angiology,  of  the  vessels ;  Neurology,  of  the  nerves ;  Splanch- 
nology, of  the  internal  viscera ;  Adenology,  of  the  glands ;  Dermatology,  of  the 
skin ;   Genesiology,  of  the  generative  organs. 

State  the  number  of  Bones  in  the  Adult  Human  Skeleton.  It  is  variously 
stated  by  different  anatomists.  Excluding  the  teeth,  the  Wormian  and  sesa- 
moid bones,  and  the  ossicles  of  the  middle  ear,  the  whole  number  would  be 
200 ;  excluding  also  the  2  patellae,  and  the  hyoid  bone,  would  leave  in  the 
skeleton  proper  197  bones. 

Describe  the  Long  Bones.  They  number  90,  act  as  supports,  or  levers, 
and  are  known  by  having  a  medullary  canal  in  the  centre  of  each,  a  shaft 
{diaphysis),  and  two  extremities.  They  are  developed  by  osseous  deposit  in 
cartilage. 

Describe  the  Short  Bones.  Numbering  30,  they  are  found  where  strength 
is  required,  but  limited  motion.  They  also  are  developed  by  osseous  deposit 
in  cartilage. 

Describe  the  Flat  Bones.  They  number  38,  protect  the  viscera  by  forming 
Falls  around  them,  and  afford  extensive  attachment  for  muscles.  They  are 
developed  by  osseous  deposit  in  membranes,  and  consists  of  2  dense  layers, 
separated  by  a  cellular  or  cancellated  osseous  tissue,  the  diploe. 

What  are  the  Irregular  Bones  ?  They  are  39  in  number,  and  include  the 
vertebrae,  sacrum,  coccyx,  the  temporal,  ethmoid,  and  sphenoid  bones,  and  the 
bones  of  the  face,  except  the  nasal,  lachrymal,  and  vomer. 

9 


10  ANATOMY. 

Name  the  Bones  of  the  Head.     They  number  22,  and  comprise  the — 
Cranial  Bones  (8) — the  frontal,  2  parietal,  occipital,  2  temporal,  the  sphenoid 

and  the  ethmoid  bones. 
Facial  Bones  (14) — 2  superior  maxillary,  2  malar,  2  nasal,  2  lachrymal^  2 

palate,  2  inferior  turbinated,  vomer  and  inferior  maxillary. 

Name  the  Bones  of  the  Trunk.     They  number  53,  as  follows,  viz.^ — 
Vertebrce  (24) — 7  cervical,  12  dorsal,  and  5  lumbar  vertebrae. 
Thorax  (25) — 7  pairs  of  true  ribs,  3  pairs  of  false  ribs,  2  pairs  of  floating  ribs, 

(articulating  with  the  bodies  of  the  dorsal  vertebrae,)  and  the  sternum. 
pelvis  (4) — the  sacrum,  the  coccyx,  and  2  ossa  innominata;  each  os  innomi- 

natum  consisting  of  3, — the  ilium,  ischium,  and  pubes. 

Name  the  Bones  of  each  Upper  Extremity.  They  number  32,  as  fol- 
lows : — 

Shoulder  (2) — the  clavicle  and  scapula. 
Arm  (i) — the  humerus. 
Forearm  (2) — the  radius  and  ulna. 
Hand  (27) — 8  carpal  bones, — the  scaphoid,  semilunar,  cuneiform,  pisiform, 

trapezium,  trapezoid,  os  magnum,  and  unciform, — 5  metacarpal,  and    14 

phalanges. ' 

Name  the  Bones  of  each  Lower  Extremity.    They  number  29,  viz. — 
Thigh  (i)— the  femur. 
Leg  (2) — the  tibia  and  fibula. 
Foot  (26) — 7  tarsal  bones, — the  astragalus,  os  calcis,  scaphoid,  cuboid,  external 

middle  and  internal  cuneiform, — 5  metatarsal,  14  phalanges. 

Name  the  Unclassified  Bones.     They  are  the — 

PatellcB  (2),  which  are  sesamoid  bones,  each  developed  in  the  tendon  of  the 
quadriceps  extensor  femoris  muscle. 

Hyoid  Bone  (i) — the  tongue-bone,  not  articulated  to  the  skeleton. 

Malleus,  Incus,  Stapes  (3  pairs) — the  bones  of  the  middle  ear. 

Sesamoid  Bones,  of  variable  number,  situated  in  the  tendons  of  the  gastrocne- 
mius and  peroneus  longus  muscles,  and  in  the  flexor  tendons  of  the  great  toe 
and  the  thumb. 

Wormian  Bones  (ossa  triqueta),  sometimes  found  in  the  cranial  sutures,  are 
not  constant  in  number  or  size. 

Name  the  principal  Eminences  on  Bones.  Heads,  are  convex  and 
smooth,  for  articulation  in  movable  joints.  Condyles,  are  irregularly  shaped 
heads.  Trochanters,  when  for  turning  the  bone.  Tuberosities,  are  broad, 
uneven  prominences.  Tubercles,  are  small  tuberosities.  Spines,  or  Spinous 
processes,  when  sharp  and  slender.     Apophysis,  is  a  process  xvhich  has  never 


BONES.  11 

been  separate  from  the  bone.     Epiphysis^  is  a  process  developed  as  a  separate 
piece  and  afterwards  united  to  the  bone  by  ossification  of  the  intermediate  tissue. 

What  other  names  are  given  to  Bony  Prominences  ?  There  are  sev- 
eral adjectives  applied  to  them  from  their  fancied  resemblances,  such  as — 
Azygos^  without  a  fellow;  Clinoid,  like  a  bed;  Coracoid^  like  a  crow's  beak; 
Coronoid,  hooked  like  a  crow's  beak;  Hamular^  hook-like;  Malleolar,  like  a 
mallet ;  Mastoid,  like  a  nipple ;  Odontoid,  tooth-like  ;  Pterygoid,  wing-like  ; 
Rostrum,  a  beak ;  Spinous,  thorn-like  ;  Styloid^  pen-like ;  Squamous,  scaly ; 
Vaginal,  ensheathing,  etc. 

Name  the  Cavities  of  Bones.  Articular  cavities  are  called  Cotyloid,  cup- 
like; 67^«c/^,  shallow ;  Trochlear,  puWey-like;  /izr<?/,  if  smooth ;  Alveolar,  ox 
Alveoli,  when  socket-like.  Non-articular  cavities  are  named  fossae,  sinuses, 
aqueducts,  foramina,  canals,  fissures,  notches,  cells,  grooves,  depressions,  etc. 

"What  is  the  Composition  of  Bone  ?  Organic  or  animal  matter,  about  y^, 
consisting  of  gelatin,  vessels  and  fat.  Inorganic,  or  mineral,  about  ^,  con- 
sisting of  phosphate  and  carbonate  of  calcium  (62^  per  cent.),  with  fluoride 
of  calcium,  phosphates  of  magnesium,  sodium,  and  chloride  of  sodium  (4^ 
percent.).  Heat  \f\\\  remove  the  organic  matter  and  leave  the  inorganic; 
dilute  Nitric  or  Hydrochloric  acid  will  remove  the  inorganic,  and  leave  the 
organic.  In  old  age  the  inorganic  constituents  predominate,  and  the  bones 
are  brittle ;  in  youth  the  organic  predominate,  and  epiphyseal  dislocation  is 
more  common  than  fracture,  especially  in  the  long  bones  of  the  extremities. 

Describe  the  Structure  of  Bone.  Bone  is  composed  of  an  outer  compact 
layer,  and  an  inner  cellular  or  spongy  structure.  It  is  surrounded,  except  at 
the  articular  cartilages,  by  a  vascular  fibrous  membrane,  the  Periosteum,  which 
receives  the  insertions  of  all  tendons,  ligaments,  etc. ;  and  the  central  cavity 
of  long  bones  is  lined  by  a  similar  structure,  the  Endosteutn.  A  transverse 
section  of  bone,  examined  microscopically,  shows — 

Haversian  Canals,  diameter  3-^^  inch,  for  the  passage  of  vessels. 
Canaliculi,  diameter  x^^iyff  inch,  radiating  from  the  canals,  and  connecting 

them  with  the  lacunae. 
Lacunce,  arranged  circularly  around  the  canals,  and  contain  the  bone- cells, 

appearing  as  irregular  dark  spaces. 
Haversian  Spaces,  connect  the  canals  with  the  medullary  spaces,  and  divide 
one  Haversian  system  from  another.     An  Haversian  System  comprises 
an  Haversian  canal  with  its  lamellae,  lacunae,  and  canaliculi. 
Concentric  Lamella  of  bone  tissue,  around  the  canals. 
Circumferential  Lamellce,  are  bone  layers  binding  the  canals  together. 
Interstitial  Lamellce,  woven  in  between  the  concentric  lamellae. 


12  ANATOMY. 

What  is  the  Marrow  of  Bone  ?  In  young  bones  a  tenacious,  transparent 
fluid,  free  from  fat.  In  adult  bones  of  a  yellow  color,  consisting  of  fat  in  vary- 
ing proportion  and  extractive  matters.  It  is  found  in  the  medullary  canal,  the 
cancellous  texture,  and  the  large  Haversian  spaces. 

What  Vessels  are  found  in  Bones  ?  Arteries,  veins,  and  some  say  lym- 
phatics.  The  Arteries  are, — the  nutrient,  entering  at  the  nutrient  foramen ; 
the  articular,  nourishing  the  cancellous  structure ;  and  the  periosteal,  which 
supply  the  periosteum  and  the  compact  structure.  The  Veins  emerge  from 
the  ends,  the  shaft,  and  from  the  nutrient  foramen. 

Describe  the  process  of  Ossification.  The  site  of  bone  is  first  occupied 
by  a  mucoid  substance,  which  becomes  temporary  cartilage  {blastema)  in  the 
second  month  of  foetal  life.  The  young  bone-cells  [osteo-blasts)  are  then  de- 
posited in  the  cartilage  at  certain  points,  and  their  deposition  and  subsequent 
pressure  cause  the  absorption  of  the  cartilage.  In  most  of  the  bones  of  the 
head  and  face,  ossification  is  intra-membranous  instead  of  intra-cartilaginous. 
Thefirtt  bones  in  which  ossification  appears  are  the  clavicle  and  inferior  max- 
illary (5th  to  7th  foetal  week);  the  last  is  the  pisiform  bone  (12th  year). 
Epiphyses  ossify  after  birth  and  begin  uniting  to  the  bone  from  the  age  of  pu- 
berty, and  in  the  inverse  order  to  that  in  which  their  ossification  began,  except 
the  lower  end  of  the  fibula,  which  ossifies  and  is  joined  to  the  shaft  earlier 
than  its  upper  end. 

THE  BONES  OF  THE  HEAD. 

THE  FRONTAL  BONE. 
Describe  the  points  on  its  vertical  portion.     They  are  as  follows: — 

Externally, — 

Frontal  Eminences,  one  on  each  side  of  the  median  line. 

Depression,  marking  the  site  of  the  frontal  suture  before  obliteration. 

Superciliary  Ridges,  behind  which  are  the  frontal  sinuses. 

Supraorbital  Notches  or  Foramina,  in  the  supraorbital  arches,  at  about  their 
inner  third,  for  the  supraprbital  vessels  and  nerves. 

Nasal  Eminence,  at  lower  end  of  the  frontal  depression. 

External  Angular  Processes,  articulate  with  the  malar  bones  and  form  th<? 
anterior  part  of  the  temporal  ridges. 

Internal  Angular  Processes,  articulate  with  the  lachrymal  bones. 

Nasal  Spine  and  Notch,  between  the  internal  angular  processes. 
Internally, — 

Groove,  for  superior  longitudinal  sinus  and  the  falx  cerebri. 

Frontal  Crest,  for  attachment  of  the  falx  cerebri. 

Foramen  Ccecum,  for  a  small  vein  to  the  longitudinal  sinus. 

Depressions  and  Elevations,  for  convolutions  of  the  brain. 


THE  PARIETAL  BONES.  13 

Between  the  two  tables  of  the  vertical  portion  in  the  adult  are  the — 
Frontal  Sinuses f  two  spaces  at  the  anterior  inferior  part  of  the  bone,  which 
are  lined  with  mucous  membrane,  and  open  into  the  middle  meatus  of  the 
nose  by  means  of  an  Infundibuhim  for  each. 
Describe  its  horizontal  portion,  or  orbital  plates.     They  each  present  the 
following  points,  viz. — 

Fossa,  for  the  lachrymal  gland,  near  the  external  angular  process. 
Depression,  at  the  nasal  margin  for  the  pulley  of  the  superior  oblique  muscle. 
Ethmoidal  Notch,  having  the  following  foramina  on  its  margin. 
Anterior  Ethmoidal  Foramen,  for  anterior  ethmoidal  vessels  and  the  nasal 

branch  of  the  ophthalmic  nerve. 
Posterior  Ethmoidal  Foramen,  for  posterior  ethmoidal  vessels. 
Grooves,  on  the  cranial  surface,  for  branches  of  the  anterior  and  middle 

meningeal  arteries. 
Describe  its  articulations,  development,  and  muscles.  The  frontal 
mrticulates  with  12  bones, — the  sphenoid,  ethmoid,  2  parietal,  2  nasal,  2  supe- 
rior maxillary,  2  lachrymal,  and  2  malar.  It  is  developed  by  2  centres  in  mem- 
brane, I  for  each  lateral  half.  The  muscles  attached  to  it  are  3  pairs, — the 
temporal,  corrugator  supercilii,  and  orbicularis  palpebrarum. 

THE   PARIETAL   BONES. 

Describe  their  general  characteristics.  They  are  2  quadrilaterally-shape<^ 
bones  situated  at  the  superior  and  lateral  regions  of  the  cranium.  The  supe- 
rior border  of  each  joins  the  other  by  the  Sagittal  Suture  ;  the  anterior  borde*" 
joins  the  frontal  bone  by  part  of  the  Coronal  Suture ;  the  posterior  border 
articulates  with  the  occipital,  forming  the  Lambdoidal  Suture ;  the  inferior 
border  with  the  sphenoid  and  temporal  bones.  Forming  the  lateral  walls  of 
the  skull  they  are  named  parietal,  from  paries,  a  wall. 

Describe  the  points  on  each  Parietal  bone.  Externally  the  bone  is  con- 
rex  and  presents  for  examination, — 

Temporal  Ridge,  continuous  with  the  same  on  the  frontal  bone. 

Parietal  Eminence,  the  point  where  ossification  commenced. 

Parietal  Foramen,  close  to  the  upper  border,  transmits  a  vein  to  the  superior 
longitudinal  sinus.     Is  not  constant. 
Internally,  the  bone  is  concave,  and  marked  by — 

Depressions  for  the  Pacchionian  bodies,  and  for  the  cerebral  convolutions. 

Furrows,  for  branches  of  the  middle  meningeal  artery. 

Groove,  for  the  lateral  sinus,  at  the  posterior  inferior  angle. 

Half-groove,  along  the  upper  border,  for  the  superior  longitudinal  sinus  of 
the  dura  mater. 
2 


14  ANATOMY. 

Describe  their  articulations,  development,  and  muscles.  Each  parietal 
bone  articulates  with  5  bones, — the  frontal,  occipital,  sphenoid,  temporal,  and 
opposite  parietal.  It  is  developed  from  i  centre  in  membrane.  The  only  muscle 
attached  to  it  is  the  temporal. 

THE   OCCIPITAL   BONE. 
Describe  its  general  features  and  surfaces.     It  is  trapezoidal  in  form, 
curved  upon  itself,  and  placed  at  the  posterior  and  inferior  region  of  the 
cranium.     Externally  its  surface  is  convex  and  presents  for  examination  the 
following,  viz. — 

External  Occipital  Protuberance ^  and  Crest,  for  the  attachment  of  the  liga- 

mentum  nuchse. 
Superior  and  Inferior  Curved  Lines,  extending  outwards  on  each  side  of 

the  external  occipital  crest. 
Foramen  Magnum,  transmitting  the  medulla  oblongata  and  its  membranes, 

the  vertebral  arteries,  and  the  spinal  accessory  nerves. 
Condyles,  2  in  number,  for  articulation  with  the  atlas  vertebra. 
Tubercles,  I  on  each  condyle,  for  the  check  ligaments. 
Anterior  Condyloid  Foramina,  2,  for  the  hypoglossal  nerves. 
Posterior  Condyloid  Foramina,  2,  (often  absent)  for  veins. 
Jugular  Processes,  2,  each  helping  to  form  the  foramen  lacerum  posterius 
basis  cranii. 
Internally,  the  surface  is  concave,  showing — 

Fossce,  4,  for  the  cerebellar  and  posterior  cerebral  lobes. 

Internal  Occipital  Protuberance,  where  6  cranial  sinuses  meet  to  form  the 

torcular  (wine-press)  Herophili. 
Crucial  Ridge,  the  vertical  portion  for  the  falx  cerebri  and  falx  cerebelli ; 
the  transverse  portion  for  the  tentorium  cerebelli,  having  also  a  groove  for 
the  lateral  sinus. 
Groove,  for   the  lateral   sinus,  and  the  inferior  petrosal  sinus,  along  the 

postero-lateral  border. 
Internal  Openings  of  the  foramina  described  above. 

Describe  the  Basilar  Process  of  the  Occipital.     It  lies  in  front  of  the 

foramen  magnum,  articulates  with  the  body  of  the  sphenoid  bone,  smooth  and 

grooved  internally  for  the  medulla  oblongata  and  pons  varolii,  which  lie  upon 

it ;  rough  inferiorly  for  the  attachment  of  muscles,  and  presenting  the — 

Pharyngeal  Spine,  for  the  attachment  of  the  superior  constrictor  muscle  of 

the  pharynx  and  its  tendinous  raphe. 
Describe  its  articulations  and  development.     The  occipital   articulates 
with    6    bones, — the    2    parietal,  2    temporal,  sphenoid,  and    atlas.      It    is 
developed  by  4  centres,  i   each  for  the  posterior  part,  the  basilar  process, 


THE  TEMPORAL  BONES. 


15 


and  the  2  ^^ondyles;   its  ossification  being  completed  about  the  6th  year  of 
age. 

What  muscles  are  attached  to  the  Occipital  Bone?  There  are  12 
muscles  attached  on  each  side  to  the  following  portions,  viz. — 

Superior  Curved  Line  3 — the  occipito-frontalis,  trapezius,  and  sterno-cleido 

mastoid. 
Space  between  the  curved  lines  2 — the  complexus  and  splenius. 
Space  below  the  inferior  curved  line  3 — the  obliquus  capitis  superior,  rectus 

capitis  posticus  major  and  minor. 
Basilar  Process  3 — the  superior  constrictor  of  the  pharynx,  rectus  capitis 

anticus  major  and  minor. 
Jugular  Process  I — the  rectus  capitis  lateralis. 

THE  TEMPORAL  BONES. 
Describe  their  situation  and  divisions.  They  are  situated  at  the  inferior 
lateral  portions  of  the  skull,  and  contain  the  organs  of  hearing.  Each  bone  is 
divided  into  3  parts,  the  Squamous «■  (scale-like).  Mastoid^  (nipple-like),  and 
Petrous c  (hard);  and  it  is  named  from  being  the  site  of  the  first  gray  hairs 
[tempus,  time). 

Describe  the  Squamous  Portion.  It  is  a  semicircular  plate,  smooth  ex- 
lernally,  and  grooved  internally  for  the  middle  meningeal  artery,  with  de- 
pressions for  the  cerebral  convolutions.     Externally  are  seen  the — 

Zygomatic    Processed   or    zygoma.  Fig.  i. 

arising  by  3  roots,  and  extend- 
ing forwards  to  articulate  with 
the  malar  bone. 

Zygomatic  Tubercle^e  at  the  base 
of  the  process,  for  the  exter- 
nal lateral  ligament  of  the  lower 
jaw. 

Eminentia  Articularis,  formed  by 
the  anterior  root  of  the  zygoma. 

Glenoid  Fossa,g  between  the  ante- 
rior and  middle  roots  of  the  zygo- 
ma ;  its  anterior  part  receives  the 
condyle  of  the  lower  jaw,  and  is 
covered  with  cartilage ;  its  posterior  part  lodges  the  parotid  gland. 

Glasserian  Fissure^  divides  the  glenoid  fossa;  it  transmits  the  laxato? 
tympani  muscle,  the  tympanic  artery,  and  the  processus  gracilis  of  the 
malleus. 


1« 


ANATOMY. 


Opening  of  the  Canal  of  Hugier,  lies  in  the  angle  between  the  squamous 
and  petrous  portions  of  the  bone ;  and  transmits  the  chorda  tympani  nerve. 

Temporal  Ridge,/  in  part. 

Describe  the  Mastoid  Portion.  It  projects  like  a  nipple  from  the  inferioi 
portion  of  the  bone  posteriorly.  Internally  it  is  grooved  for  the  lateral  sinus ;« 
externally  are  seen  the — 

Mastoid  Foramen^h  the  largest  of  several  foramina,  for  a  vein. 

Mastoid  Process,  at  the  tip,  for  the  stemo-cleido-mastoid,  splenius,  and 
trachelo-mastoid  muscles. 

Digastric  Fossa  J  for  the  posterior  belly  of  the  digastric  muscle. 

Occipital  Groove,^  for  the  occipital  artery. 

Mastoid  Cells,  in  the  interior  of  the  mastoid  process,  open  on  the  posterior 
wall  of  the  middle  ear,  and  are  lined  with  mucous  membrane. 

Describe  the  Petrous  Portion,  It  is  very  hard,  pyramidal  in  form,  con- 
tains the  internal  and  middle  ear,  projects  inwards  and  forwards,  and  presents 
a  base,  an  apex,  three  surfaces,  and  three  borders. 

On  the  Base  are  seen,  the — 


Fig.  2. 


Meatus  Auditorius  Externus,i  the 
external  opening  of  the  ear. 

Auditory  Process,  a  bony  ring  for  the 
external  cartilage  of  the  ear. 

Apex  lies  internally,  at  the  base  of  the 
skull,  forming  the  outer  boundary  of 
the  foramen  lacerum  medium,  and 
contains  the  internal  carotid  canal. 

Anterior  Surface,  presents  from  within, 
outwards — 

Opening  of  the  Carotid  Canal}^  for 
the    internal    carotid    artery   and 
plexus. 
Depression,  for  the  Gasserian  ganglion  of  the  5th  pair  of  cranial  nerves. 
Hiatus  Fallopii,  for  great  petrosal  nerve  and  an  artery. 
Foramen,  for  small  petrosal  nerve. 

Eminence,  over  the  superior  semicircular  canal  of  the  ear. 
Depression,  over  the  tympanum. 
Posterior  Surface,  presents — 
Meatus  Auditorius  Internus^^  transmits  the  7th  and  8th  pairs  of  cranial 

nerves  and  the  auditory  artery,  and  lodges  a  process  of  dura  mater. 
Opening  of  the  Aqueductus  Vestibuli}^  transmits  to  the  vestibule  a  small 
artery  and  vein,  and  lodges  a  process  of  dura  mater. 


THE  TEMPORAL  BONES.  17 

Inferior  surface,  presents  from  within  outwards — 

Rough   Quadrilateral  Surface^^  for  the  origin  of  the  tensor  tympani  and 

levator  palati  muscles. 
Opening  of  the  Carotid  Canal,  transmitting  the  internal  carotid  artery,  and 

the  carotid  plexus  of  the  sympathetic  nerve. 
Aqueductus  Cochlea,  transmitting  a  vein  from  the  cochlea. 
Jugular  Fossa,  a  depression  for  the  sinus  of  the  internal  jugular  vein,  form- 
ing with  the  occipital  bone  the  foramen  lacerum  posterius,  which  trans- 
mits that  vein  and  the  8th  pair  of  cranial  nerves,  etc.     {^See  page  35.) 
Foramen  for  Jacobson^s  Nerve  (tympanic  branch  of  the  glosso-pharyngeal), 

in  the  ridge  between  the  jugular  fossa  and  the  carotid  canal. 
Foramen  for  Arnold's  Nerve  (auricular  branch  of  the  pneumogastric),  in 

the  outer  wall  of  the  jugular  fossa. 
Jugular  Surface,  for  articulation  with  the  jugular  process  of  the  occipital  bone. 
Vaginal  Process,t  ensheathing  the  root  of  the  styloid  process. 
Styloid  Process}^  a  long  projection  for  the  stylo-pharyngeus,  stylo-hyoid, 
and  stylo-glossus  muscles  (3);    and  the   stylo-hyoid  and  stylo-maxillary 
ligaments  (2),  which  are  attached  thereto. 
Stylo-mastoid  Foramen}^  between  the  styloid  and  mastoid  processes,  for  the 

exit  of  the  facial  nerve,  and  the  entrance  of  the  stylo-mastoid  artery. 
Auricular  Fissure^  for  the  exit  of  Arnold's  nerve. 
In  the  angle  between  the  petrous  and  squamous  portions,  are  seen  the — 

Septum  Tubce,  a  lamina  separating  the  following  canals.     Its  inner  end  pro- 
jects into  the  tympanum,  and  is  called  the  Processus  cochleariformis. 
Opening  of  the  canal  for  the  tensor  tympani  muscle. 
Osseous  Opening  of  the  Eustachian  tube  «  inferiorly. 
The  Anterior  Border  articulates  partly  with  the  spinous  process  of  the  sphe- 
noid bone. 
The  Posterior  Border  assists  in  forming  the  jugular  foramen,  and  is  grooved 

for  the  inferior  petrosal  sinus. 
The  Superior  Border  separates  the  anterior  fossa  of  the  skull  from  the  middle 
fossa ;  to  it  is  attached  the  tentorium  cerebelli,  and  it  is  grooved  for  the  su- 
perior petrosal  sinus.'^ 

Describe  its  articulations  and  development.  The  temporal  articulates 
with  5  bones, — the  occipital,  parietal,  sphenoid,  malar,  and  inferior  maxillary. 
It  is  developed  by  4  centres,  one  each  for  the  squamous  portion,  styloid  pro- 
cess, and  auditory  process,  and  one  for  the  petrous  and  mastoid  portions.  Its 
ossification  is  completed  about  the  2d  or  3d  year. 

What  muscles  are  attached  to  it  ?  There  are  14  muscles  attached  to  the 
following-named  portions.     To  the — 

Squamous  Portion  2, — ^the  temporal  and  masseter, 
2*  T. 


18 


ANATOMY. 


Mastoid  Portion  6, — the  occipito-frontalis,  sterno-cleido-mastoid,  splenius 

capitis,  trachelo-mastoid,  digastric,  and  retrahens  aurem. 
Petrous  Portion  3, — the  tensor  tympani,  levator  palati,  and  stapedius. 
Styloid  Process  3, — the  stylo-glossus,  stylo-hyoid,  and  stylo-pharyngeus. 

THE  SPHENOID  BONE. 

Describe  its  Position  and  Form.  Wedged  in  between  the  bones  of  the 
skull  anteriorly,  it  resembles  a  bat  with  out-stretched  wings.  It  is  named 
from  the  Greek  word  aipiiv  spkane,  a  wedge,  enters  into  the  formation  of  5 
cavities,  4  fossae,  3  fissures,  and  has — 

A  Body.  2  Pterygoid  Processes.  12  Foramina. 

2  Greater  Wings.^  2  Styloid  Processes.  12  pairs  of  Muscles. 

2  Lesser  Wings.*  6  Clinoid  Processes.  12  Articulations. 

10  Points  of  Ossification.  3  Lesser  Processes. 

Describe  the  Body  of  the  Sphenoid  Bone.  Placed  in  the  median  line, 
cuboid  in  shape,  it  presents  on  its  Upper  Surface  from  before  backwards, 
the  following  points,  viz. — 

Pj^  Ethmoidal  Spine^  ar- 

ticulating with   the 
ethmoid  bone. 
A     Smooth     Surface^ 
grooved  for  the  ol- 
factory nerves. 
Optic  Groove,  support- 
ing the  commissure 
of  the  optic  nerves. 
Olivary    Process,    an 
olive  -  shaped    emi- 
nence    behind    the 
optic  groove. 

Middle  Clinoid  Processes,  bounding  the  sella  Turcica  in  front. 
Sella  Turcica^^  (Turkish  saddle),  lodges  the  pituitary  body  and  the  circular 

sinus  of  the  brain. 
Dorsum  Sella  (back  of  the  saddle),  grooved  for  the  6th  nerves. 
Posterior  Clinoid  Processes,^  for  attachment  of  the  tentorium  cerebelli. 
Grooves,  laterally,  for  the  cavernous  sinus  and  internal  carotid  artery. 

The  posterior  surface  is  rough  and  quadrilateral  :^5  ft  articulates  with  the 
basilar  process  of  the  occipital  bone,  ossification  being  completed  from  the 
1 8th  to  the  20th  year. 


THE  SPHENOID  BONE. 


19 


The  ANTERIOR  SURFACE  15  nearly  vertical,  and  presents  the — 

Lamella,  in  the  median  line,  articulating  with  the  perpendicular  plate  of 

the  ethmoid  bone,  and  forming  part  of  the  nasal  septum. 
Opening  of  the  Sphenoidal  Sinuses, e    or  cavities  in    the  body  of  the  bone 

which  exist  in  adults,  not  in  children. 
Sphenoidal  Turbinated  Bones  (pyramids  of  Wistar),  which  partially  close 

the  sinuses,  and  articulate  with  the  ethmoid  and  palate  bones. 
The  INFERIOR  SURFACE  helps  to  form  the  nasal  fossae,  and  presents  the — 
Rostruni,d  which  articulates  with  a  groove  on  the  vomer. 
Vaginal  Processes,  I  on  each  side  of  the  rostrum. 
Ptery go-palatine  Grooves,  which,  with  the  sphenoidal  processes  of  the  palate 

bones,  form  the  ptery  go-palatine  canals,  for  the  transmission  of  the  pterygo- 
palatine arteries  and  nerves. 
Describe   the   Greater   Wings  of  the   Sphenoid.      Each  wing,   on   its 
SUPERIOR  SURFACE,  presents  the  following  points,  viz. — 
Foramen      Rotun- 

dum^     for     the 

superior       max- 
illary      division 

of  the  5th. 
Foramen      Ovale? 

for    the   inferior 

maxillary     divi- 
sion of  the    5th 

n  erve ,       the 

small      petrosal 

nerve,   and    the 

small    m  e  n  - 

ingeal  artery.  •■    "       /y?n  irr* 

Foramen  Vesalii,  transmitting  a  small  vein. 
Foramen  Spinosum}^  transmitting  the  middle  meningeal  artery. 
The  ANTERIOR  SURFACE  assists   in  forming  the  external  wall  of  the  orbit,  the 
spheno-maxillary  and  sphenoidal  fissures.     It  articulates  with  the  frontal  and 
malar  bones,  and  presents  a — 

Notch,  transmitting  a  branch  of  the  ophthalmic  artery. 

Spine,  for  part  of  the  lower  head  of  the  external  rectus  muscle. 

External  Orbital  Foramina,  transmitting  arterial  branches. 
The  external  surface  presents  the  following  points, — 
Pterygoid  Ridge,  dividing  the  temporal  fossa  from  the  zygomatic. 
Spine  of  the  Sphenoid}^  to  which  are  attached  the  internal  latemal  ligament 

of  the  lower  jaw,  and  the  laxator  tympani  muscle. 


0  ANATOMY. 

The  circumference  is  partly  serrated  for  articulation  with  the  temporal  and 
frontal  bones,  and  partly  smooth  for  the  anterior  margin  of  the  foramen 
lacerum  medium  and  the  inferior  margin  of  the  sphenoidal  fissure,  which 
margins  it  assists  in  forming. 

Describe  the  Lesser  Wings  ^  of  the  Sphenoid.  Called  also  the  Pro- 
c^ses  of  Ingrassias,'!  they  terminate  internally  in  the  Anterior  Clinoid  /'r^- 
r«jej  /  ^  their  anterior  borders  articulate  with  the  orbital  plate  of  the  frontal 
Done,  the  posterior  are  free,  dividing  the  anterior  cerebral  fossa  from  the 
middle.     Connected  intimately  with  each  of  these  wings  are  the — 

Optic  Foramen,^  formed  by  the  separation  of  its  roots,  and  transmitting  the 

optic  nerve  and  the  ophthalmic  ai-tery. 
Sphenoidal  Fissure^  or  foramen  lacerum  anterius,^  is  bounded  above  by 
the  lesser  wing,  below  by  the  greater  wing,  and    transmits  the  3d,  4th, 
ophthalmic  division  of  the  5th,  and  the  6th  nerves,  the  ophthalmic  vein, 
branches  of  the  lachrymal  and  middle  meningeal  arteries,  some  filaments 
of  the  sympathetic  nerve,  and  a  process  of  the  dura  mater. 
Describe  the   Pterj'goid    Processes   of  the  Sphenoid.      The   wing-like, 
processes  descend,  i   on  each  side  of  the  body,  and  divide  each  into  2  thin, 
bony  plates,^;^  connected  together  anteriorly,  and  presenting — 

Pterygoid  Fossa ^  between  the  plates  posteriorly,  the  origin  of  the  external 

pterygoid  muscle. 
Scaphoid  Fossa,  at  the  base  of  the  internal  plate,  serves  as  the  origin  of  the 

tensor  palati  muscle. 
Hamular  Process,  a  hook-like  projection  at  the  apex  of  the  internal  plate, 

around  which  plays  the  tendon  of  the  tensor  palati  muscle. 
Vidian  Canal}^  at  the  root  of  the  process,  for  the  Vidian  nerve  and  vessels. 
Triangular  Notch,  at  the  end  of  the  process,  articulates  with  the  pterygoid 

process  of  the  palate  bone. 
With  what  bones  does  the  Sphenoid  articulate?     With   12,  the  other 
7  bones   of   the  cranium  and  5    of    the  face, — the  vomer,    2    malar,   and  2 
palate. 

How  is  the  Sphenoid  developed  ?  By  10  centres,  as  follows. — 2  for  the 
greater  wings,  2  for  the  lesser  wings  and  anterior  part  of  the  body,  2  for  the 
posterior  part  of  the  body,  2  for  the  pterygoid  processes,  and  2  for  the  sphe- 
noidal turbinated  processes.  Ossification  begins  in  the  2d  foetal  month,  and  is 
completed  about  the  nth  year,  by  the  union  of  the  turbinated  processes  with 
the  body. 

What  muscles  are  attached  to  the  Sphenoid  bone?  There  are  12 
pairs,  as  follows,  viz. — 

Orbital  muscles ^  6 — all  except  the  inferior  oblique  of  the  eye. 


THE  ETHMOID  BONE.  2J 

Muscles  of  Mastication^  3 — the  temporal,  external  and  internal  pterygoids. 
Superior  constrictor,  tensor  palati,  and  laxator  tympani,  3. 

THE  ETHMOID  BONE. 
Describe  its   General   Characteristics.        It  is  a  spongy,  light  bone,  de- 
pending from  the  ethmoidal  notch  of  the  frontal,  and  from  between  its  orbital 
plates.     It  consists  of  a  body  and  2  lateral  masses,  and  is  named  from  the  Greek 
word  ^dfiog,  aythmos,  a  sieve. 

What  are  the  Points  on  its  Body?     The  body<5  consists  of  a  horizontal 
or  cribriform  plate,  and  a  perpendicular  plate,  and  presents  the — 
Crista   Gallif  or  cock's  comb,  projecting  up- 
wards, for  the  attachment  of  the  anterior  end 
of  the  falx  cerebri. 
Cribriform  Plate,^  on  each  side  of  the  crista 
gain.        It    is    concave    for    the    olfactory 
bulbs,^  and  perforated  for  the  transmission 
of   the   olfactory  nerves,   the   nasal   branch 
of   the    ophthalmic    nerve,    and    numerous 
small  vessels. 
Perpendicular  Plate^tt  assists  to  form  the  nasal 
septum,   is    usually   inclined    to    one    side, 
grooved     for     filaments     of    the     olfactory 
nerves,  and  has  attached  to  it  the  cartilage  of  the  nose. 
Describe  the   Lateral   Masses.       They  consist  of  a  number  of  cellular 
cavities,  and  each  one  presents  the  following  points,  viz. — 

Ethmoid  Cells,  the  anterior  opening  by  the  infundibulum  into  the  middle 

meatus  of  the  nose,  the  posterior  into  the  superior  meatus. 
Os  Planum,^  or  orbital  plate,  helps  to  form  the  inner  wall  of  the  orbit,  and  is 
notched  superiorly  to  form  with  the  frontal  bone  the  two  ethmoidal  foramina. 
Unciform  Process,  descends  to  articulate  with  the  inferior  turbinated,  and 

forms  part  of  the  inner  wall  of  the  antrum. 
Superior  Turbinated  Process,/  curves  downwards  and  outwards. 
Middle  Turbinated  Process, g  is  larger  and  more  curved  than  the  superior. 
These  processes  bound  the  superior  meatus  of  the  nose,  and  are  often 
called  the  superior  and  middle  turbinated  bones. 
Describe    its  articulations,  development,  and  muscles.       The    ethmoid 
articulates  with  15  bones,  viz. — all  those  of  the  face  except  the  malar,  and  the 
frontal  and  sphenoid  of  the  cranium.     It  is  developed  by  3  centres,  i  for  each 
lateral  mass,  and  i  for  the  body,  ossification  being  completed  about  the  6tli 
year.     There  are  no  muscles  attached  to  it. 


22  ANATOMY. 

THE  NASAL  BONES. 

Describe  them.  They  are  2  small  bones  forming  the  bridge  of  the  nose  by 
articulation  with  each  other  in  the  median  line.  They  are  convex  exter- 
nally, concave  internally,  and  grooved  for  the  external  branch  of  the  nzisal 
nerve  and  for  small  arteries.  They  each  articulate  with  4  bones, — the  frontal, 
ethmoid,  superior  maxillary,  and  the  opposite  nasal ;  are  each  developed  by  one 
centre  of  ossification,  and  have  no  muscles  attached  to  them. 

THE  SUPERIOR  MAXILLARY  BONES. 

Describe  them.  They  are  2  hollow  bones,  together  forming  the  upper 
jaw.  Each  bone  consists  of  4  processes,  and  a  body  which  possesses  a  large 
cavity,  the  antrum  of  Highmore. 

Describe  the  Antrum  of  Highmore.     It  is  a  pyramidal  cavity  in  the  body  of 
the  bone,  and  opens  into  the  middle  meatus  of  the  nose  by  an  aperture  which 
is  very  small  in  the  recent  subject,  admitting  only  a  small  probe.     Its  walls  are 
very  thin,  and  are  covered  internally  by  a  mucous  membrane.   It  presents  the — 
Aperture^  partly  closed   by  the  articulation  of  the  unciform  process  of  the 
ethmoid  with  the  ethmoidal  process  of  the  inferior  turbinated ;  and  that 
of  the  maxillary  process  of  the  palate  with  a  fissure  in  the  superior  maxil- 
lary ;  also  by  the  maxillary  process  of  the  inferior  turbinated  which  hooks 
over  the  lower  edge  of  the  orifice. 
Posterior  Dental  Canals^  on  the  posterior  wall  of  the  cavity. 
Processes  in  its  floor,  formed  by  the  alveoli  of  the  ist  and  2d  molar  teeth, 

the  roots  of  which  occasionally  perforate  it. 
What  other  points    are    presented    by  the    body?      The  body  has  4 

surfaces,  the  facial  externally,  the  zygomatic 
posteriorly,  the  orbital  superiorly,  and  an 
internal  surface  forming  part  of  the  outer 
wall  of  the  nose  and  the  cavity  of  the 
mouth.     It  presents  the — 

Incisive    Fossa?   on   the   facial    surface, 
above  the  incisor  sockets,  for  the  origin 
of  the  depressor  alse  nasi  muscle. 
Canine  Fossa}  more  externally,  for  the 

levator  anguli  oris. 
Infraorbital  Foramen?  above  the  ca- 
nine fossa,  transmitting  the  infraor- 
bital vessels  and  nerve,  from  the  in- 
fraorbital canal  in  the  orbital  surface 
of  the  bone. 


THE  SUPERIOR   MAXILLARY   BONES.  23 

Maxillary  Tuberosity,  articulates  with  the  tuberosity  of  the  palate  bone. 
Turbinated  Crests,  inferior  and  superior,  on  the   inner  surface,  bounding 

horizontal  grooves  which  correspond  to  the  meati  of  the  nose. 
Vertical  Grooves,  on  the  inner  surface,  one  assisting  to  form  the  nasal  duct, 

the  other  to  form  the  posterior  palatine  canal. 
Rough  Surface,  for  articulation  with  the  palate  bone. 
Orbital  Surface,  articulating  with  the  lachrymal,  ethmoid,  and  palate  bones 

interiorly,  partly  bounding  the  spheno-maxillary  fissure  exteriorly,  and 

forming  the  lower  margin  of  the  orbit  anteriorly. 
Infraorbital  Groove,  along  the  orbital  surface,  ending  in  the  infraorbital 

canal  and  foramen.     (See  ante.) 
Depression^  for  the  origin  of  the  inferior  oblique  muscle  of  the  eye. 

Describe  its  Processes.     They  number  4,  as  follows. — 
Malar  Process,*  is  triangular,  looks  outwards  from  the  body,  and  is  rough 

for  articulation  with  the  malar  bone. 
Nasal  Process,^  is  thin    anteriorly  and   serrated   superiorly  for  articulation 

with  the  nasal  bone;  posteriorly  it  is  smooth  and  articulates  with  the  lachry- 
mal.    It  presents  the — 

Turbinated  Crests,  superior  and  inferior,  the  former  articulating  with  the 
middle  turbinated  process  of  the  ethmoid  bone. 

Outer  Surface,  gives  origin  to  the  orbicularis  palpebrarum  and  levator  labii 
superioris  alaeque  nasi  muscles,  and  the  tendo  oculi. 

Groove  on  the  posterior  border,  helping  to  form  the  nasal  duct. 
,  «.lveolar  Process,  forms  the  curved  line  of  the  teeth,  and  presents — 

Alveoli,  or  sockets,  for  8  teeth  in  the  adult,  5  in  the  child. 
Palate  Process,  forms  part  of  the  floor  of  the  nasal  cavity,  and  the  roof  of 

the  mouth.     It  articulates  with  the  vomer,  the  palate  bone,  and  with  its 

fellow  process,  and  presents  the — 

Incisive  Foramen,  or  foramen  of  Stenson,  leading  into  the  anterior  palatine 
canal,  for  the  anterior  palatine  vessels. 

Foramina  of  Scarpa,  2,  transmitting  the  naso-palatine  nerves. 

Groove  on  the  under  surface,  for  the  protection  of  the  vessels  and  nerves. 

Orifice  of  the  posterior  palatine  canal,  at  the  posterior  end. 

Nasal  Crest,  at  the  articulation  of  the  two  processes  with  the  vomer. 

Anterior  Nasal  Spine,  the  anterior  extremity  of  the  nasal  crest. 

Describe  its  articulations  and  development.  The  superior  maxillary 
articulates  with  9  bones, — the  frontal,^^  ethmoid,^*  vomer,^^  nasal,^^  lachrymal, 
malar,  palate,  inferior  turbinated,  and  opposite  superior  maxillary .^^^  It  is  de' 
veloped  probably  by  4  centres, — i  for  the  facial  and  nasal  parts,  another  for  the 
orbital  and  malar,  a  3d  for  the  incisive,  and  a  4th  for  the  palate  portion. 


24  ANATOMY. 

What  muscles  are  attached  to  it?     There  are   ii,  viz. — the  orbicularis 

palpebrarum,  and  levator  anguli  oris  alaeque  nasi,  2,  to  the  nasal  process  ; — the 
levator  labii  superioris,  levator  anguli  oris,  compressor  naris,  depressor  alse 
nasi,  orbicularis  oris,  and  inferior  oblique  of  the  eye,  6,  to  the  body ; — the  buc- 
cinator, I,  to  the  alveolar  process  ; — the  masseter,  i,  ioihe.  malar  process  ; — and 
the  external  pterygoid,  i,  to  the  tuberosity. 

THE   LACHRYMAL   BONES. 

Describe  them.  They  are  2  small  quadrilateral-shaped  bones,  situated  in 
the  anterior  part  of  the  inner  wall  of  the  orbit.     Each  presents  a — 

Groove,  on  the  external  surface,  forming  part  of  the  nasal  duct. 

Ridge,  also  externally,  for  attachment  of  the  tensor  tarsi  muscle. 

Furrow,  internally,  corresponding  to  the  ridge  on  the  external  surface. 

Hamular  Process,  projecting  downwards  to  articulate  with  the  lachrymal 
process  of  the  inferior  turbinated  bone. 

Internal  Surface,  closes  the  anterior  ethmoidal  cells. 

Describe  its  articulations,  development,  and  muscles.  The  lachry- 
mal articulates  with  4  bones, — the  frontal,  ethmoid,  superior  maxillary,  and 
inferior  turbinated.  It  is  developed  irom  i  centre,  and  has  but  i  muscle  attached 
to  it,  the  tensor  tarsi,  or  Horner's  muscle. 

THE   MALAR  BONES. 

Describe  them.  The  cheek  bones  are  situated  at  the  outer  and  upper  part 
of  the  face,  aiding  to  form  the  cavities  of  the  orbits  and  the  temporal  and  zyg- 
omatic fossoe.     Each  presents  an — 

External  Surface,  convex,  for  attachment  of  the  zygomatic  muscles. 
Foramen,  externally,  for  the  malar  branch  of  the  temporo-malar  nerve. 
Foramen,c  internally,  for  the  temporal  branch  of  the  same  nerve. 
Frontal  Process,^'  articulates  with  the  external  angular  process  of  the  frontal. 
Orbital  Process, i  projecting  backwards,  forming  part  of  the  floor  and  outer 
wall  of  the  orbit,  as  well  as  part  of  the  temporal  fossa,  and  bounds  th« 
spheno-maxillary  fissure  anteriorly. 
Fig.  7.  Zygomatic    Process,/  projecting    backwards    to    articulate 

with  the  zygomatic  process  of  the  temporal  bone  by  a 
serrated  edge. 
Upper  B order, b  forms  the  outer  and  inferior  margin  of  th« 

orbit. 
Lower  Border,  thick  and  rough,  for  the  origin  of  the  ma* 
seter  muscle. 

Anterior  Border,d  articulates  with  the  superior  maxillary  bone. 
Posterior  Border^  terminates  the  temporal  fossa  below. 


THE   PALATE  BONES.  25 

Name  its  articulations,  centres,  and  muscles.  The  malar  articulates 
with  4  bones, — the  frontal,  sphenoid,  temporal,  and  superior  maxillary.  It  is 
developed  by  one  centre  of  ossification,  and  has  5  muscles  attached  to  it, — the 
levator  labii  superioris,  zygomaticus  major  and  minor,  masseter  and  temporal. 

THE  PALATE  BONES. 
Describe  them.  They  are  2  irregularly-shaped  bones,  situated  poste- 
riorly  in  the  nares.  Each  bone  assists  in  forming  the  floor  and  outer  wall  of 
the  nose,  the  roof  of  the  mouth,  the  floor  of  the  orbit,  the  inner  wall  of  th* 
antrum,  the  zygomatic,  spheno-maxillary,  and  pterygoid  fossae,  and  presents  the 
following  points. — 

Horizontal  plate,  «  completes  the  nasal  floor  and  hard  palate ;  has  a — 
Ridge,  on  the  inferior  surface,  for  the  tensor  palati  aponeurosis. 
Groove,  assisting  to  form  the  posterior  palatine  canal. 
Foramina,   transmitting   the    anterior    and    posterior 

palatine  nerves. 
Anterior  Border^  is  serrated,  and  joins  the  superior 

maxillary  bones. 
Posterior  Border,  is  free  and  concave,  for  the  attach- 
ment of  the  soft  palate. 
Inner  Border, d  is  thick,  and  articulates  with  its  fel- 
low, forming  a  groove  for  the  reception  of  the  vomer. 
Its  posterior  extremity  is  the — 
Posterior  Nasal  Spine,  for  the  origin  of  the   azygos 
uvulae  muscle. 

Vertical  plate,^  a  broad  and  thick  lamella,  presents  the  following  : — 
Superior  Turbinated  Crest,  on  the  inner  surface.     Below  it  is  the — 
Inferior  Turbinated  Crest,g  dividing  the  middle  meatus  of  the  nose  from 

the  inferior,  and  articulating  with  the  inferior  turbinated  bone. 
Posterior  Border,  articulates  with  the  pterygoid  process  of  the  sphenoid. 
Groove,  on  the  external  surface,  helping  to  form  the  posterior  palatine  canal. 
Two  Smooth  Surfaces,  externally,  one  forming  the  inner  wall  of  the  zygo- 
matic fossa;  the  other,  part  of  the  inner  wall  of  the  antrum. 
Two  Rough  Surfaces,  also  externally,  one  for  articulation  with  the  superior 

maxillary ;  the  other  with  the  pterygoid  process  of  the  sphenoid. 
Deep  Notch,   which   by   articulation  with   the   sphenoid   bone,   forms  the 
spheno-palatine  foramen,^  for  the  spheno-palatine  nerves. 
Pterygoid  process,<^  is  wedged  into  the  notch  between  the  plates  of  the  ptery- 
goid process  of  the  sphenoid,  with  which  it  articulates  laterally.    In  it  are  the—* 
Palatine  Foramina,  for  the  external  and  posterior  palatine  nerves. 
Posterior  Surface,  aids  in  forming  the  pterygoid  fossa. 
8 


26  ANATOMY. 

Orbital  process,'  triangular  in  shape,  large  and  hollow.     It  has — 

Three  Articular  Surfaces,  for  the  sup.  maxillary,  sphenoid,  and  ethmoid. 

Two  Free  Surfaces,  the  orbital  forming  part  of  the  floor  of  the  orbit,  tha 
external  aiding  to  form  the  zygomatic  fossa. 

Rounded  Border,  forms  a  part  of  the  spheno-maxillary  fissure. 
Sphenoidal  process,/  projects  backwards,   articulates   superiorly   with   the 

body  of  the   sphenoid,  and   externally   with   the   pterygoid  process  of  the 

sphenoid.     On  its  upper  surface  is  a — 

Groove,  which  assists  in  forming  the  pterygo-palatine  canal. 

Inner  Surface,  forms  part  of  the  outer  wall  of  the  nasal  fossa. 

Describe  its  articulations,  development,  and  muscles.  The  palate 
articulates  with  6  bones, — the  sphenoid,  ethmoid,  vomer,  superior  maxillary, 
inferior  turbinated,  and  its  fellow  palate  bone.  It  is  developed  by  one  centre  at 
the  junction  of  the  two  plates.  There  are  5  muscles  attached  to  it, — the  azygos 
uvula;,  internal  and  external  pteiygoids,  superior  constrictor,  and  tensor  palatL 

THE   INFERIOR  TURBINATED  BONES. 
Describe  them.     They  are  2  thin  curved  osseous  plates   situated   in  the 
nasal  fossae,  their  convex  surfaces  presenting  inwardly.     Each  bone  is  attached 
above  to  the  inferior  turbinated   crests  of  the  superior  maxillary  and  palate 
bones,  and  presents  the  following,  viz. — 

Lachrymal  Process?  aiding  to  form   the   nasal 
'*^"  ^*  duct,  by  articulation  with  the  lachrymal  and 

*^^?^^%r^  superior  maxillary  bones. 

Ethmoidal  Process}  articulating  with  the  unci- 
form process  of  the  ethmoid,  thus  helping  to 
partially  close  the  aperture  of  the  antrum. 
Maxillary  Process,^  also  helps  to  partially  close  the  aperture  of  the  antrum, 

by  hooking'  over  the  lower  edge  of  that  orifice. 
Free  Border,^  below,  coming  to  about  y^  inch  above  the  floor  of  the  nose. 
Name   its  articulations ^  centres,  and  muscles.     The  inferior  turbinated 
articulates  with  4  bones,  the  ethmoid,  lachrymal,  palate,   and  superior  max- 
illary.    It  is  developed  by  one  centre,  and  has  no  muscles  attached  to  it. 

THE  VOMER. 
Describe  it.     The   vomer   (plough-share)  forms   the   postero-inferior  part 
Fig.  10.  of  the  nasal  septum,  but  is  usually  bent  to  or.e 

side.     Its — 

Superior  Border}  '^  has  a  groove  and  two  alae 
or  wings,  for  articulation  with  the  rostrum 
and  vaginal  processes  of  the  sphenoid  bone. 


THE  INFERIOR   MAXILLARY   BONE.  27 

Anterior  Border^  is  grooved  for  the  ethmoidal  plate  and  the  nasal  cartilage. 

Inferior  Border,^  the  longest,  articulates  with  the  nasal  crest  of  the  superior 
maxillary  and  palate  bones. 

Posterior  Border,  is  free  and  presents  towards  the  pharynx. 

Naso-palatine  Grooves,  laterally,  for  the  naso-palatine  nerves. 

Furrows,  on  the  lateral  surfaces,^  for  vessels  and  nerve-filaments. 

Name  its  articulations,  centres,  and  muscles.  The  vomer  a?'ticulates 
with  6  bones, — the  sphenoid,  ethmoid,  2  superior  maxillary,  and  2  palate 
bones.  It  i«  developed  by  one  centre,  which  appears  about  the  6th  foetal  week 
in  cartilage  between  two  laminae  which  coalesce  after  puberty.  It  has  no 
muscles  attached  to  it. 

THE   INFERIOR   MAXILLARY  BONE. 

Describe  its  general  characteristics.  The  inferior  maxillary  bone  forms 
the  lower  jaw,  receives  the  inferior  teeth,  and  is  the  second  bone  of  the  body 
in  which  ossification  appears,  the  clavicle  being  the  first.  It  consists  of  a  body 
and  two  rami. 

Describe  the  Body  of  the  bone.  It  is  shaped  somewhat  like  a  horse- 
shoe, and  presents  for  examination  the  following:  viz. — 

Alveolar  Portion,  above  the  oblique  line,  containing  on  its  upper  border 

alveoli  for  16  teeth  in  the  adult,  for  10  in  the  child. 
Symphysis,  a  vertical  ridge  on  the  median  line,  marking  the  junction  of  the 

two  symmetrical  portions  of  which  the  bone  originally  consisted. 
Mental  Process,  a  prominent  triangular  eminence,  forming  the  chin. 
Externally  on  each  side  from  the  symphysis  backwards,  are  the — 
Incisive  Fossa,  above  the  chin,  for 
the  origin  of  the  levator  menti. 
Mental  Foramen,  below  the   2d 
bicuspid   alveolus,  transmitting 
the  mental  artery  and  nerve. 
External  Oblique   Line,   for   the 
origins  of   the    depressor  labii 
inferioris  and  depressor  anguli 
oris  muscles  from   its  anterior 
half 
Groove,  near   the   angle,  for   the 
facial  artery. 

Internally,  on  each  side  from  the  median  depression  backwards,  are  the — 
Genial  Tubercles,  the  superior  for  the  genio-hyo-glossus  muscle;  the  inferior 

for  the  genio-hyoid. 
Mylo-kyoid  Ridge,  obliquely  backwards,  for  the  mylo-hyoid  muscle. 


mo  anatomy. 

Sublingual  Fossa,  near  the  genial  tubercles,  for  the  sublingual  gland. 

Fossa,  below  the  sublingual,  for  the  anterior  belly  of  the  digastric  muscle. 

Submaxillary  Fossa,  below  the  ridge,  for  the  submaxillary  gland. 

Describe  the  Rami  of  the  Inferior  Maxillary.  The  rami,  or  ascending 
portions  of  the  bone,  are  2  in  number,  and  each  present  the — 

Coronoid  Process,  anteriorly,  for  the  insertion  of  the  temporal  muscle. 

Condyloid  Process,  posteriorly.  Its  condyle  articulates  with  the  glenoid 
fossa  of  the  temporal  bone,  its  neck  receives  the  insertion  of  the  external 
pterygoid  muscle,  its  tubercle  has  attached  to  it  the  external  lateral  liga- 
ment of  the  lower  jaw. 

Sigvioid  Notch,  a  deep  depression  separating  the  above-named  processes 
from  each  other,  and  crossed  by  the  masseteric  vessels  and  nerve. 

Groove,  on  the  coronoid  process  internally,  and  prolonged  downwards  upon 
the  body,  for  the  attachment  of  the  buccinator  muscle. 

Ridges,  on  the  external  surface,  for  the  insertion  of  the  masseter. 

Spine,  a  projection  on  the  internal  surface,  for  the  attachment  of  the  internal 
lateral  ligament  of  the  jaw. 

Inferior  Dental  Canal,  opening  behind  the  spine,  lies  within  the  ramus  and 
body  of  the  bone  for  the  inferior  dental  vessels  and  nerve.  It  communi- 
cates with  each  alveolus  and  with  the  mental  foramen. 

Mylo-hyoid  Groove,  below  the  spine,  for  the  mylo-hyoid  vessels  and  nerve. 

Rough  SurfacCy  behind  the  groove,  for  the  internal  pterygoid  muscle. 

Angle  of  the  Jaw,  at  the  junction  of  the  posterior  body  of  the  ramus  with 
the  inferior  border  of  the  body,  for  the  insertion  of  the  masseter  and  in- 
ternal pterygoid  muscles,  and  the  stylo-maxillary  ligament. 

Describe  the  Articulations  and  Development  of  the  Inferior  Max- 
illary bone.  It  articulates  with  one  pair  of  bones, — the  temporal.  It  is  the 
earliest  formed  bone  in  the  body  except  the  clavicle,  and  is  probably  developed 
by  2  centres,  one  for  each  lateral  half,  the  two  halves  coalescing  at  the 
symphysis  about  the  ist  year  of  age.  In  adult  life  the  ramus  arises  almost 
vertically  from  the  body,  and  the  dental  canal  lies  about  the  middle  of  the 
body.  In  old  age  the  ramus  extends  obliquely  backwards,  the  angle  becoming 
very  obtuse ;  and  the  alveolar  portion  being  absorbed,  the  dental  canal  is  near 
the  superior  border. 

What  Muscles  are  attached  to  the  Inferior  Maxillary?  They 
number  15  pairs, — the  masseter,  internal  and  external  pterygoids  and  temporal, 
4,  to  the  ramus ; — the  genio-hyo-glossus,  genio-hyoid,  mylo-nyoid,  digastric, 
and  superior  constrictor,  5,  to  the  internal  surface  oi  the  body ;— the  depressor 
labii  inferioris,  depressor  anguli  oris,  levator  menti,  orbicularis  oris,  platysma 
myoides,  and  buccinator,  6,  to  the  external  surface  of  the  body. 


THE   ORBITS. 


THE  ORBITS. 
Describe  the  Orbital  Cavities.  The  orbits  are  2  conoidal  cavities, 
situated  between  the  forehead  and  the  face,  their  bases  outwards,  their  apices 
pointing  backwards,  the  lines  of  axial  prolongation  meeting  at  the  sella 
turcica  of  the  sphenoid  bone.  They  contain  the  organs  of  vision  with  their 
appendages,  and  are  each  formed  by  7  bones, — the  frontal,^  ethmoid,^  sphe- 
noid,^ *■  8  lachrymal ,6  superior  maxillary,'  palate,^  and  malar ,»  of  which  the 
first  three  are  common  to  both  orbits.  Each  orbit  communicates  with  i  cavity 
and  4  fossae,  as  follows,  viz. — 

Cavity  of  the  cranium,  by  the  optic  foramen  ^^  and  sphenoidal  fissure. ^° 
Fossce  (4) — the  nasal,  temporal,  zygomatic,  and  sphenomaxillary, — by  the 
nasal  duct^'^  and  the  spheno-maxillary  fissure,^' 

What  Foramina  communicate  with  each  orbit  ?  Nine, — the  optic 
foramen,^^  sphenoidal  fissure,^"  anterior  21  and  posterior  22  ethmoidal  foramina, 
supraorbital,^*  infraorbital,^^  and  malar  foramina,'^  the  nasal  duct,!'  ^nd  the 
spheno-maxillary  fissure. ^^ 

Describe   the   Roof  of  the  Orbit.     Formed  by  the  orbital  plate  of  the 


frontal  bone  anteriorly,^  and  the 
lesser  wing  of  the  sphenoid*  pos- 
teriorly, it  is  concave,  and  presents 
the — 

Lachrymal  Fossa^  at  its  outer 
angle,for  the  lachrymal  gland. 
Depressions^  at  the  inner  angle, 
for  the  pulley  of  the  superior 
oblique. 
Describe    the    Floor  of    the 
Orbit,       Formed    by  the   orbital 
surface  of  the  superior  maxillary 
bone,''  and  the  orbital  process  of 
the  malar 9  and  palate  bones,'  it 
is  nearly  flat  and  presents  the — 
Palato-maxillary  Suture  poste- 
riorly. 
Infraorbital  Canal,  and  a  De- 
pression    for     the     superior 
oblique   muscle  of  the   eye, 
anteriorly. 
Infraorbital    Groove}^    poste- 
riorly, 
3* 


Fig.  12. 


30  ANATOMY. 

Describe  the  Inner  Wall  of  the  Orbit.  Formed  by  the  nasal  process 
of  the  superior  maxillary  bone,20  the  lachrymal,^  the  os  planum  of  the  ethmoid,'^ 
and  the  body  of  the  sphenoid,^  it  presents — 

A  Groove,  for  the  lachrymal  sac,  and  the  Lachrymal  Crest,  anteriorly. 

2  Sutures, — the  ethmo-lachrymal,  and  the  ethmo-sphenoidal. 

Describe  the  Outer  Wall  of  the  Orbit.  Formed  by  the  orbital  pro- 
cess of  the  malar  bone,'  and  the  greater  wing  of  the  sphenoid,^  it  presents  the 
Orifices^^  of  the  malar  canals,  and  the  Spheno-malar  Suture. 

Describe  the  Angles  of  the  Orbit.     They  present  the  following  points. 
In  the  superior  external  angle. 

Sphenoidal  Fisstire}^  or  foramen  lacerum  anterius,  transmits  the  3d,  4th, 
ophthalmic  division  of  the  5th,  and  the  6th  nerves,  the  ophthalmic  vein, 
branches  of  the  lachrymal  and  middle  meningeal  arteries,  filaments  of 
the  sympathetic  nerve,  and  a  process  of  the  dura  mater. 
Articulations, — the  fronto-malar,  and  fronto-sphenoidal. 
In  the  superior  internal  angle. 

Suture, — the  lachrymo-ethmo-frontal,  in  which  are  the  following  foramina. 
Anterior  Ethmoidal  Foramen,"^^  transmitting  the  anterior  ethmoidal  artery 

and  the  nasal  nerve. 
Posterior  Ethmoidal  Foramen^"^  transmitting  the  posterior  ethmoidal  artery 
and  vein. 
In  the  inferior  external  angle. 

Spheno-maxillary  Fissure^^  (described  under  the  Zygomatic  Fossa). 
In  the  inferior  internal  angle. 

A  Suture,  the  ethmo-maxillo-palato-lachrymal. 

What  other  points  are  connected  with  the  Orbit?  Two,  the  supra- 
rvfbital  notch,  and  the  optic  foramen,  as  follows,  viz. — 

Supraorbital  Notch  or  Foramen}^  at  the  junction  of  the  inner  and  middle 
thirds  of  the  upper  circumference,  transmitting  the  supraorbital  artery, 
veins,  and  nerve.  A  line  prolonged  from  this  notch  through  the  interval 
between  the  bicuspid  teeth  of  either  jaw,  will  cross  both  the  infraorbital 
and  mental  foramina,  and  the  canine  fossa  of  the  superior  maxillary  bone. 

Optic  Foramen}'^  at  the  apex,  is  formed  by  the  2  roots  of  the  lesser  wing 
of  the  sphenoid,  and  transmits  the  optic  nerve  and  the  ophthalmic  artery. 
From  around  its  margin  arises  a  tendinous  ring,  the  common  origin  of  the 
4  recti  muscles  of  the  eye. 

What  Muscles  arise  within  the  Orbit  ?  The  4  recti  and  2  oblique  of  the 
eye,  the  levator  palpebrae,  and  the  tensor  tarsi  (8  in  all). 


THE  FOSSyE. 


THE  FOSSiE. 

Describe  the  Nasal  Fossae.  Together  they  form  the  cavity  of  the  nose, 
Deing  separated  from  each  other  by  the  Sephim  Nasi^^  They  open  in  front 
by  the  anterior  nares,  behind  by  the  posterior  nares ;  and  extend  from  the 
palate  processes  of  the  superior  maxillary  and  palate  bones,^''  upwards  to  the 
base  of  the  cranium.  They  are  formed  by  14  bones, — the  ethmoid,  sphenoidj 
frontal,  vomer,  2  nasal,  2  superior  maxillary,  2  lachrymal,  2  palate,  and  2 
inferior  turbinated. 

Describe  the  Septum  Nasi.^^  It  forms  the  inner  wall  of  each  nasal 
fossa,  and  is  formed  chiefly  by  the  perpendicular  plate  of  the  ethmoid  bone, 
the  vomer,  and  the  triangular  cartilage  of  the  septum ;  to  a  less  extent  by  5 
other  bones, — the  rostrum  of  the  sphenoid,  the  nasal  spine  of  the  frontal,  and 
the  crests  of  the  nasal,  palate,  and  superior  maxillary  bones. 

Describe  the  points  presented  by  each  Nasal  Fossa.     They  are — 
On  the  roof. 

Openings,  posteriorly,  into  the  sphenoidal  sinuses. 

Olfactory  Foramina^  and  the  Nasal  Slity  in  the  cribriform  plate  of  the  eth- 
moid bone. 

On  the  floor. 

Orifice,  of  the  anterior  palatine  canal. 

Suture,  between  the  bones  forming  the  hard  palate. 

Nasal  Spines^  anterior  and  posterior,  and  the  Ridge  connecting  them. 
On  the  outer  wall,  from  above  downwards. 

Superior  Turbinated  process  of  Fig.  13. 

the  ethmoid. 

Superior  Meatus  of  the  nose,  into 
which  open  3  orifices, — those 
of  the  posterior  ethmoidal  and 
the  sphenoidal  smuses,  and  the 
sphenopalatine  foramen. 

Middle  Turbinated''  process  of 
the  ethmoid. 

Middle  Meatus  of  the  nose,  into 

which  open    2   orifices, — those 

of  the  antrum^*  and  infundib- 

ulum, — the  latter  draining  the 

anterior  ethmoidal  cells,^  and  the  frontal  sinus 
Inferior  Turbinated  Bone}^  below  which  is  the- 


S2  ANATOBIY. 

Inferior  Meatus  of  the  nose,  the  largest ;  into  it  open  2  orifices, — those  of 
the  lachrymal,  and  anterior  palatine  canals.  To  these  may  be  added  the 
anterior  and  posterior  nares. 

Describe  the  Temporal  Fossa.  Situated  on  each  side  of  the  cranium, 
it  is  shallow  above  and  behind,  but  deep  in  front  and  below;  and  is  formed 
by  parts  of  5  bones, — the  frontal,  sphenoid,  temporal,  parietal,  and  malar.  It 
is  bounded  above  and  behind  by  the  temporal  ridge,  in  front  by  the  malar 
frontal  and  sphenoid  bones,  and  below  by  the  zygoma  and  the  pterygoid  ridge 
on  the  greater  wing  of  the  sphenoid.  It  is  traversed  by  6  sutures, — the 
spheno-malar,  spheno-frontal,  spheno-parietal,  spheno-temporal,  fronto-parietal, 
and  temporo-parietal.  It  opens  below  into  the  zygomatic  fossa ;  and  lodges  the 
temporal  muscle,  and  the  deep  temporal  vessels. 

Describe  the  Zygomatic  Fossa.  Extending  downwards  from  the  tem- 
poral fossa,  it  is  thus  bounded, — 

In  fronts  by  the  tuberosity  of  the  superior  maxillary  bone. 

Externally,  by  the  zygoma,  and  the  ramus  of  the  inf.  maxillai>^. 

Internally,  by  the  external   plate  of  the  pteryj^oid  process. 

Abcrvey  by  the  temporal  fossa,  the  squamous  portion  of  the  temporal  bone, 
and  the  greater  wing  of  the  sphenoid. 

Below,  by  the  alveolar  border  of  the  inferior  maxillary  bone. 

What  Fissures  open  into  the  Zygomatic  Fossa.     Two,  the — 
Spheno-maxillary  Fissure,  between  the  greater  wing  of  the  sphenoid  externally, 

and  the  superior   maxillary  and  palate  bones  internally.      It  connects  the 

orbit  with  the  zygomatic,  temporal,  and  spheno-maxillary  fossae ;  and  trans- 
mits the  infraorbital  artery,  the  superior  maxillary   nerve   and   its  orbital 

branches,  and  the  ascending  branches  of  Meckel's  ganglion. 
Pterygo-m axillary   Fissure,  between  the  tuberosity  of  the  superior  maxillary 

bone  and  the  pterygoid  process  of  the  sphenoid.     It  transmits  branches  of 

the  internal  maxillary  artery,  and  connects   the   zygomatic   fossa   with  the 

spheno-maxillary. 

Describe  the  Spheno-Maxillary  Fossa.  It  is  a  triangular  cavity  be- 
tween the  pterygoid  process  of  the  sphenoid  bone  and  the  tuberosity  of  the 
superior  maxillary,  and  is  situated  at  the  junction  of  the  spheno-maxillary, 
pterygo-maxillary,  and  sphenoidal  fissures.     Into  it  open — 

J  FosscB, — the  orl:)ital,  zygomatic,  and  nasal. 

2  Cavities, — the  cranial,  and  buccal. 

^  Foramina, — the  Vidian  and  pterygo-palak.4ie  canals,  and  the  foramen 
rotundum,  posteriorly;  the  spheno-palatine  foramen  on  the  inner  wall; 
and  the  posterior  palatine  canal  inferiorly ,— -occasionally  also  the  acceS' 
scry  palatine  canals. 


THE  SUTURES  AND  FONTANELLES.  BS 

THE   SUTURES   AND   FONTANELLES. 

Name  the  Sutures  of  the  skull.     There  are  17. 
4i  the  Vertex  of  the  skull  are  5,  the — 

Sagittal,  or  interparietal. 

2  Coronal,  or  fronto-parietal.     2  Lambdoid,  or  occipito-parietaL 
At  the  Sides  of  the  skull  are  4,  the — 

2  Spheno-parietal.     2  Temporo-parietal. 
At  the  Base  of  the  skull  are  5,  the — 

2  Temporo-occipital.     Basilar,  in  the  central  line  of  the  base. 

2  Temporo-sphenoidal. 
In  the  Mesial  line,   besides  the  sagittal  and  basilar,  are  3,  the — 

Spheno-ethmoidal.     Spheno-frontal.     Ethmo- frontal. 

Describe  the  Facial  Sutures.  The  most  important  are  the  following,  but 
the  sutures  of  the  face  are  very  numerous. 

Zygomatic  Suture,  at  the  temporo-malar  articulation. 

Transverse  Suture,  extending  from  one  external  angular  process  of  the 
frontal  bone  across  to  the  other,  and  connecting  that  bone  with  the  malar, 
sphenoid,  ethmoid,  lachrymal,  superior  maxillary,  and  nasal  bones. 

Symphysis  of  the  Chin,  the  site  of  a  foetal  suture. 

How  are  the  Sutures  formed  ?  By  dentations  of  the  external  tables  in- 
terdigitating  with  each  other,  the  adjacent  edges  of  the  internal  tables  lying  in 
unjoined  proximity.  The  sutures  are  not  formed  until  a  long  time  after  the 
formation  of  the  skull,  probably  to  permit  of  the  marginal  growth  of  the  bones. 

What  are  the  Fontanelles  ?  They  are  6  membranous  intervals  in  the  in- 
fant's skull,  corresponding  in  situation  with  the  angles  of  the  two  parietal 
bones.     They  are  as  follows,  viz. — 

Anterior,  at  the  junction  of  the  sagittal  and  coronal  intervals. 

Posterior^  at  the  junction  of  the  sagittal  and  lambdoid  intervals. 

Lateral  Fontanelles,  4,  two  at  the  anterior  inferioi  angles,  and  two  at  the 
posterior  inferior  angles  of  the  parietal  bones. 

Describe  the  Wormian  Bones.  They  are  supernumerary  small  pieces 
of  bone,  irregularly  shaped,  and  developed  by  special  centres  in  unclosed  por- 
tions of  the  cranial  sutures  and  fontanelles,  being  more  frequent  in  the  lamb 
doid  suture.      They  are  also  called  "ossa  triqueta"  from  their  triangular  form. 

Describe  the  Hyoid  Bone.  It  is  shaped  like  a  horse-shoe,  has  no  articu- 
lation with  the  skeleton,  but  supports  the  tongue.  It  consists  of  a  Body,  two 
greater,  and  two  lesser  Cornua  or  horns.  On  the  body  is  a  Crucial  Ridge, 
with  a  Tubercle  at  the  centre.  It  is  developed  hy  5  centres, — one  for  the  body 
and  one  lor  each  horn.  Attached  to  it  are  lo  muscles,  3  ligaments,  and  I 
membrane,  as  follows,  viz. — 

c 


S4  ANATOMY. 

To  the  Body, — the  genio-,  mylo-,  stylo-,  sterno-,  thyro-,  omo-hyoid,  the  genio- 
hyo-glossus,  and  the  hyo-glossus  muscles;  also  the  pulley  of  the  digas- 
tric, the  hyo-epiglottic  ligament,  and  the  thyro-hyoid  membrane. 

To  the  Greater  Cornu, — the  hyo-glossus,  middle  constrictor  muscles,  and 
part  of  the  thyro-hyoid ; — also  the  thyro-hyoid  ligament. 

To  the  Lesser  Cornu, — the  stylo-hyoid  ligament. 

TABLE  OF  THE  FORAMINA  AT  THE  BASE  OF  THE  SKULL, 

with  the  various  structures  transmitted  by  each. 

Anterior  Fossa  contains  i  single  foramen  and  5  in  pairs,  viz. — 
Foramen  Ccecum, — lodges  a  fold  of  dura  mater,  and  transmits  a  vein  to  the 

longitudinal  sinus  from  the  nose,  sometimes  one  from  the  frontal  sinus. 
Ethmoidal  Fissure, — the  nasal  nerve,  and  the  anterior  ethmoidal  artery. 
Olfactory, — olfactory  nerves,  and  nasal  branches  of  the  ethmoidal  arteries. 
Anterior  Ethmoidal, — anterior  ethmoidal  artery  and  the  nasal  nerve. 
Posterior  Ethmoidal, — posterior  ethmoidal  artery  and  vein. 
Optic  Foramen,— opXc  nerve  and  ophthalmic  artery. 
Middle  Fossae  contain  8  pairs,  viz. — 

Foramen  Lacerum  Anterius,ox  Sphenoidal  Fissure, P — the  3d,  4th,  oph- 
thalmic division  of  the  5th,  ami  the  6th  cranial  nerves,  and  filaments  of 
pjg^  J ._  the  sympathetic ;  ophthalmic  vein, 

a  branch  of  the  lachrymal  artery, 
orbital  branches  of  the  middle 
meningeal  artery,  and  a  process 
of  dura  mater. 
Foramen  Rotundum, — superior  max- 
illary division  of  the  5th  cranial 
nerve. 
Foramen    Vesalii,  —  a    small    vein. 

This  foramen  is  often  absent. 
Foramen  Ovale,  t —  inferior  max- 
illary division  of  the  5th  nerve, 
lesser  petrosal  nerve,  and  the 
small  meningeal  branch  of  the 
internal  maxillary  artery. 
Foramen  Spinosum,  ^ — middle  men- 
ingeal artery,  meningeal  veins, 
and  sympathetic  filaments  from  the 
cavernous  plexus. 


THE  CRANIAL   FORAMINA.  35 

Foramen  Lacerum  Medium,q — internal  carotid  artery,  carotid  plexus,  large 
petrosal  nerve,  and  a  branch  from  the  ascending  pharyngeal  artery. 
■  Small  Foramen, — lesser  petrosal  nerve. 
Hiatus  Fallopii, — large  petrosal  nerve,  branch  of  middle  meningeal  artery. 

Posterior  Fossa  contains  6  pairs  and  i  single,  viz. — 

Meatus  Auditorius  Intermis, — facial  and  auditory  nerves,  auditory  artery. 
Aqueductus  Vestibuli, — small  artery  and  vein,  process  of  dura  mater. 
Foramen  Lacertitn  Fosterius,''' — glosso-pharyngeal,  pneumo-gastric,  and  spinal 

accessory  nerves,  internal  jugular  vein,  meningeal  branches  of  the  ascend 

ing  pharyngeal  and  occipital  arteries. 
Mastoid  Foramen    (often    absent), — small   vein,   occasionally   the   mastoid 

artery. 
Anterior  Condyloid  Foramen, — hypoglossal  nerve,  meningeal  branch  from 

the  ascending  pharyngeal  artery. 
Posterior  Condyloid  Foramen^"  (often  absent),  posterior  condyloid  vein. 
Foramen  Magnum,k — medulla  oblongata  and  its  membranes,  the  vertebral 

arteries,  and  the  spinal  accessory  nerves. 

Externally,  at  the  base  of  the  skull  are  lo  pairs,  viz. — 
Opening  of  the  Eustachian  Tube, — air  to  the  middle  ear. 
opening  of  Tensor  Tympani  Canal, — the  tensor  tympani  muscle. 
Orifice  of  the  Vidian  Canal, — the  Vidian  nerve,  and  vessels. 
Glasserian  Fissuve,n — laxator  tympani  muscle,  tympanic   artery,  processus 

gracilis  of  the  malleus. 
Orifice  of  the  Canal  of  Hugier, — chorda  tympani  nerve. 
Foramen  for  Jacobson's  Nerve, — tympanic  branch  of  glosso-phaiyngeal. 
Foravien  for  Arnold's  Nerve, — auricular  branch  of  pneumogastric. 
Opening  of  the  Aqueductus  Cochlea, — vein  to  the  cochlea. 
Stylo-mastoid  Foramen^t — facial  nerve,  stylo-mastoid  artery. 
Auricular  Fissure, — exit  of  Arnold's  nerve. 

Face  presents  3  pairs,  viz. — 

Supraorbital  Foramen  or  Notch, — supraorbital  artery,  vein,  and  nerve. 
Infraorbital  Foramen, — infraorbital  artery  and  nerve. 
Mental  Foramen, — mental  artery  and  nerve. 

Palate  presents,  on  each  side  at  least  6  pairs,  viz. — 

Incisive  Foramina^  (one  or  two), — nerves  and  vessels  to  the  incisor  teeth. 
2  Anterior  Palatine, — anterior  palatine  vessels,  naso-palatine  nerves. 
Posterior  Palatine, — posterior  palatine  vessels,  anterior  palatine  nerve. 
Accessory  Palatine  Foramina  (one  or  two), — posterior  palatine  nerves. 
Pterygo-palatine  Foramen^ — pterygo-palatine  vessels. 


86 


ANATOMY. 


Fig.  is. 


THE    BONES    OF    THE    TRUNK. 
THE  VERTEBRAL  COLUMN. 

What  Cnaracteristics  are  Common  to  the  Vertebrae  ?  Each  vcKtebra 
consists  of  a  body  and  an  arch,  the  latter  being  formed  by  2  pedicles  and  2 
laminae,  which  support  7  processes. 

Body^  is  thick  and  spongy,  convex  in  front''  from  side  to  side,  concave  verti- 
cally, and  on  the  upper  and  lower  surfaces,  which  are  surrounded  by  a 
bony  rim.  Anteriorly  are  small  foramina  for  nutrient  vessels,  posteriorly 
a  large  foramen  for  the  exit  of  the  vense  basis  vertebrarum. 
Pedicles,  project  backwards  from  the  body,  inclining  outwards.  They  are 
notched  above  and  below,  thus  forming,  with  the  adjacent  notches,  the 
Intervertebral  Foramina  for  the  entrance  of  vessels  and  the  exit  of  the 
spinal  nerves. 
Lamina:^  are  2  broad  plates,  meeting  in  the  spinous  process  behind,  and 
rough  on  their  upper  and  lower  borders  for  the  attachment  of  the  liga- 
mentum  subflava. 

Transverse     Processes,^    one 
on    each   side,   projecting 
outwards. 
Articular  Processes,  two  on 
each   side,   superior  ^   and 
inferior,*  project  from  the 
junction    of    the    laminae 
and   pedicles,  and   articu- 
lating   above    and    below 
with    the     articular     pro- 
cesses    of     the     adjacent 
vertebrae.      Their  superior 
facets    look    upwards     in 
the    cervical    region,    out- 
wards in  the   dorsal,  and 
inwards  in  the  lumbar. 
Spinous     Process}     projects 
backwards  from  the  junc- 
tion  of   the   laminae  with 
each      other,      sometimes 
very  obliquely. 
Spinal  Foratnen^  is  the  space  enclosed  by  the  body,  pedicles,  and  laminae  ; 
and  which,  when  the  vertebrae  are  articulated,  forms  part  of  the  spinal 
canal. 


THE  VERTEBRAL  COLUMN.  37 

How  are  the  Vertebrae  distinguished?  As  cervical  (7),  dorsal  (12),  anu 
lumbar  (5).  Each  of  these  divisions  has  several  peculiar  features,  but  their 
especial  characteristics  are  as  follows. 

The  Cervical  Vertebra;  are  pierced  at  the  bases  of  their  transverse  processes  by 
the  vertebral  foramina,  which  transmit  the  vertebral  artery,  vein,  and  plexus. 
The  Dorsal  Vertebra;  have  facets  and  demifacets  on  their  bodies,  for  articula- 
tion with  the  heads  of  the  ribs. 
The  Ltimbar  Vertebra  are  marked  by  the  absence  of  the  foramina  and  facets 

which  distinguish  the  other  two  classes. 
What  are  the   Peculiar  Vertebrae?     They  are  9  in  number, — the  atlas 
or  1st  cervical,  the  axis  or  2d  cervical,  the  vertebra  prominens  or  7th  cervical, 
the  1st,  9th,  loth,  nth,  and  12th  dorsal,  and  the  5th  lumbar. 

The  Atlas  is  a  bony  ring  supporting  the  head.  A  bony  arch  takes  the  place 
of  a  body,  and  its  spinous  process  is  a"  mere  tubercle.  Its  Lateral  Masses 
form  its  chief  bulk,  supporting  large  Articular  Processes  which  all  look 
inwards,  the  superior  articulating  with  the  condyles  of  the  occipital  bone. 
The  Axis  is  marked  by  its  Odontoid  Process  projecting  upwards  from  the 
body  into  the  anterior  part  of  the  spinal  foramen  of  the  atlas,  where  it 
articulates  with  the  anterior  arch,  and  receives  the  occipito-axoid  and  the 
check  ligaments. 
The  Vertebra  Prominens  has  a  long  and  prominent  spinous  process  which 

ends  in  a  tubercle  for  the  ligamentum  nuchae. 
The  Dorsal  Vertebra.     The  1st  has  one  facet  and  ademifacet.     The  9th  has 
a  demifacet  only.     The  loth  has  but  one  facet  on  the  body  and  one  on 
the  transverse  process.     The  nth  and  12th  have  each  but  one  facet  on 
the  body,  and  none  on  the  transverse  processes.     The  12th  resembles  a 
lumbar  vertebra  in  size  and  shape. 
The  £th  Lumbar  is  much  deeper  in  front  than  behind ;  its  spinous  process  is 
small,  but  its  transverse  processes  are  large  and  thick,  and  point  slightly 
upwards. 
What  important  Relations  have  Certain  Vertebrae? 
The  jd  Cervical  corresponds  to — the  bifurcation  of  the  common  carotid  artery, 

and  the  superior  cervical  ganglion. 
The^th  Cervical,  to — the  junctions  of  the  larynx  with  the  trachea,  and  the  phar- 
ynx with  the  oesophagus,  and  the  middle  cervical  ganglion  of  the  sympathetic. 
The  2d  Lumbar,  to — the  junction  of  the   duodenum  with   the  jejunum,  the 
commencement  of  the   thoracic    duct   and   the   portal  vein,  the  origin  of 
the   superior   mesenteric   artery,   the   lower  margin  of    the   pancreas,  the 
opening  of  the  ductus  communis  chol^dochus,  the  lower  end  of  the  spinal 
cord,  and  the  crura  of  the  diaphragm. 
[The  false  vertebrae  are  described  as  hones  of  the  pelvis.] 
4 


S8 


ANATOMY. 


Describe  it. 

Fig.  i6. 


THE   THORAX. 

What  is  the  Thorax?  An  osseo-cartilaginous  cage  formed  by  the  bodit- 
of  the  dorsal  vertebrae  posteriorly,  the  ribs  and  costal  cartilages  laterally,  and 
the  sternum  in  front.  Its  shape  is  conical,  the  axis  inclined  forwards,  the  bast 
below  and  closed  by  the  diaphragm. 

What  Structures  pass  through  its  Apex?  The  trachea,  oesophagus, 
large  vessels  of  the  neck,  pneumogastric,  phrenic  and  sympathetic  nerves, 
thoracic  duct,  and  in  inspiration  the  apex  of  the  lung. 

What  Structures  are  contained  in  its  Cavity?  The  trachea,  bronchi 
and  lungs,  the  heart  and  great  vessels,  internal  mammary  arteries,  azygos  and 
bronchial  veins,  pneumogastric,  phrenic,  and  splanchnic  nerves,  oesophagus, 
thoracic  duct,  lymphatic  vessels,  and  glands. 

THE   STERNUM. 

The  sternum,  or  breast-bone,  consists  of  3  parts, — the  manu- 
brium,^  or  handle;  the  gladiolus,'^  or  sword;  and  the  ensi- 
form  or  xiphoid  appendix.^^    It  presents  the — 
Interclavicular  Notch,  on  its  superior  border. 
Manubrium,'^  articulates  with  the  clavicle,^   ist  costal 

cartilage,^  and  a  part  of  the  2d./" 
Gladiolus,  articulates  with  the  costal  cartilages  from  the 
3d  to  the  6th  inclusive,  and  partly  with  the  2d  and  7th. 
Ensiform  Appendix  (the  tip),  articulates  with  the  carti- 
lage of  the  false  ribs,  and  in  part  with  the  7th  costal 
cartilage./ 
Describe  its  development  and  muscles.  The  ster- 
num is  developed  by  6  centres,  I  each  for  the  manubrium 
and  ensiform  aooendix,  and  4  for  the  gladiolus.  The  mus- 
cles attached  to  it  are  9  pairs  and  one  single  muscle, — 
the  sterno-cleido-mastoid,  sterno-hyoid,  and  sterno-thyroid,. 
3,  to  its  upper  part ; — the  rectus  abdominis,  external  and  internal  oblique,  trans- 
versalis,  and  the  diaphragm,  5,  to  its  lower  part; — the  pectoralis  major,  i,  an- 
teriorly ; — and  the  triangularis  sterni,  i,  posteriorly. 


THE   RIBS. 

Describe  them.  There  are  12  ribs  on  each  side,  of  which  7  are  "trne 
ribs,"  being  each  connected  to  the  sternum  by  a  separate  cartilage; — and  5  are 
"  false  ribs."  Three  of  the  latter  are  connected  by  their  cartilages  to  the  carti- 
lage of  the  7th  rib,  while  two  are  called  "  floating  ribs,"  having  each  one  ex- 
tremity free. 

What  are  the  Characteristics  Common  to  most  of  the  Ribs  ?  They  each 
consist  of  a  head,  neck,  and  shaft,  and  present  the  following  points,  viz. — 


THE  RIBS. 


39 


IIead,a  is  divided  by  a  ridge  into  2  facets,  which  articulate  with  the  facets  on 
the  bodies  of  the  dorsal  vertebrae  ;  the  ridge  giving  attachment  to  the  in- 
terarticular  ligament. 

Neck,  about  an  inch  long,  having  attached  to  its  upper  border  the  anterior 
costo-transverse  ligament,  to  its  posterior  surface  the  middle  costo-trans- 
verse  ligament ;   its  anterior  surface  is  smooth. 

Tuber  osity,^ 
at  the  June-  a  Fig.  17. 

tion  of  the 
neck  with 
the  shaft, 
has  a  facet 
for  articula- 
t  io  n  with 
the  trans- 
verse pro- 
cess of  the 
next  lower 
vertebra,  and  a  rough  surface  for  the  posterior  costo-transverse  ligament. 

Shaft,  twisted  on  itself,  is  concave  internally,  convex  externally,  its  uppef 
border  round  and  smooth,  its  lower  border  grooved'^  for  the  intercostal 
'vessels  and  nerves.     At  its  external  extremity^  is  an  oval  depression  for 
the  insertion  of  the  costal  cartilage. 

Angle,e  just  in  front  of  the  tuberosity,  is  marked  by  a  rough  line,  to  which 
are  attached  the  muscles  of  the  deep  layer  of  the  back, 

Hov7  are  they  developed?  Each  rib  has  3  centres,  one  each  for  the 
head,  shaft,  and  tuberosity.  The  last  2  ribs,  having  no  tuberosity,  are  devel- 
oped each  by  2  centres. 

Describe  the  Peculiar  Ribs.  They  are  the  ist,  2d,  loth,  nth,  and  12th. 
They  respectively  present  the  following  peculiarities,  viz. — 

ist  Rib,  is  broad,  short,  not 
twisted,  has  no  angle,  only  one 
facet  on  the  head  \a.  but  on  its 
upper  surface  are  seen  two 
grooves  for  the  subclavian  ar- 
tery*^ and  vein,^  and  between 
them  a  tubercles  for  the  scale- 
nus anticus  muscle. 

2d  Rib,  is  not  twisted,  its  tuber- 
osity and  angle  are  very  close 
together,  and  its  upper  surface  presents  rough  surfaces  for  the  serratus 
magnus  and  scalenus  posticus  muscles. 


40 


ANATOMY. 


jotk  Rib,  has  but  one  facet  on  its  head. 

iiih  Rib,  has  no  neck,  no  tuberosity,  and  but  one  facet  on  its  head. 

I2th  Rib,  has  neither  neck,  angle,  tuberosity  nor  groove,  and  but  one  facet 

THE  PELVIS. 

Describe  the  Pelvis.  It  is  formed  by  the  sacrum,  coccyx,  and  two  ossa 
Innominata,  and  is  divided  into, — \\\&  false  pelvis,  comprising  the  upper  and 
expanded  portion, — and  the  true  pelvis,  below  the  ilio-pectineal  line.  The 
false  pelvis  corresponds  to  the  iliac  fossae,  and  is  marked  by  its  walls  being 
deficient  anteriorly  between  the  iliac  borders,  and  posteriorly  between  the 
sacrum  and  the  posterior  iliac  spines.     The  true  pelvis  has  a — 

Brim,  or  inlet,  bounded  in  front  by  the  crest  and  spine  of  the  pubes,  benind 
by  the  promontory  of  the  sacrum,  laterally  by  the  ilio-pectineal  line,  its 
axis  corresponds  to  a  line  from  the  umbilicus  to  the  middle  of  the  coccyx. 
Its  average  diameters  in  the  female  are, — 4  inches  antero-posteriorly,^  over 
5  inches  transversely,'  under  5  inches  obliquely.'     In  the  male  each  of 

these  measurements  is   about 
P^«-  »9-  Yz  an  inch  less. 

Cavity,     is     a     short     curved 
canal,   connecting    the    brim 
with  the  outlet.     In  nont  its 
depth     is    about     i>'^'     inch, 
posteriorly   4  to   4^4    inches 
in    the   female,    4^    to   5^ 
inches     in     the    male.       Its 
diameter  is  about  4^"  inches 
in  the  female,  4^^  inches  in 
the  male,  all  around. 
Outlet,  is  bounded  by  the  pubic  arch  above,  the  tip  of  the  coccyx  behind, 
and  the  tuberosities  of  the  ischii  laterally.     Its  axis,  if  prolonged,  would 
touch  the  promontory  of  the  sacrum.     Its  diameters  in  the  female  are 
each  about  4^4!'  inches,  in  the  male  about  3^  inches. 
State  the  chief  differences  between  the  male  and  female  pelves.     The  male 
pelvis  is  marked  by  strength  of  the  bones,  prominence  of  the  muscular  impres- 
sions, a  deep  and  narrow  cavity,  and  large  obturator  foramina.    Th.Q  female  pel- 
z/zVhas  lighter  bones,  broader  iliac  fossae,  the  spines  being  further  apart,  greater 
diameters  at  every  point,  the  sacrum  less  curved,  and  the  pubic  arch  wider. 

Describe  the  Sacrum.  The  '*  sacred  bone  "  is  triangular,  curved,  with  its 
convexity  backwards,  and  is  situated  base  upwards  between  the  ossa  innominata, 
forming  with  the  coccyx  the  posterior  wall  of  the  pelvis.  The  bone  is  formed 
by  the  coalescence  of  5  vertebrae,  and  presents  the  following  points,  viz — 


THE   PELVIS. 


41 


Fig.  20. 


^   Ridges,^  transversely  across  both  surfaces,  mark  the  union  of  its  original 

segments. 
8  Anterior  Sacral  Foramina,  for  the  anterior  sacral  nerves. 
8  Grooves^  shallow  and  broad,  for  the  aforesaid  nerves. 
Promontory,  at  its  junction  with  the  last  lumbar  vertebrae. 
8  Posterior  Sacral  Foramina,  for  the  posterior  sacral 

nerves. 
Tubercles^  representing  the  spinous  processes  of  the 

segments. 
Groove,  posteriorly,  on   each   side   of  the   spinous 

tubercles. 
2  Cornua,  at  the  posterior  inferior  portion  of  the 

bone. 
Auricular  Surface^  on  each  side,  articulates  with 

the  ilium. 

Notch,  laterally  and  inferiorly,  for  the  5th  sacral  nerve. 
Base^  has  all  the  characteristics  of  the  lumbar  vertebrae,  with  the  last  of 

which  it  articulates. 
Apex}^  has  an  oval  surface  for  articulation  with  the  coccyx. 
Sacral  Canal,  the  continuation  of  the  spinal,  is  incomplete  posteriorly  at  its 

lower  end.     It  transmits  the  Cauda  Equina  ;  into  it  open  the  sacral  fora- 

mina  laterally. 


Fig.  21. 


Describe  the  Coccyx.  It  consists  of  4  or  5  rudimentary  vertebrae  coalesced 
into  a  triangular  bone,  the  base^  of  which  articulates  with  the  apex  of  the 
sacrum.  Its  posterior  surface  is  rough  for  muscles  and  liga- 
ments, its  anterior  surface  is  smooth  and  marked  by  ridges  at 
the  junction  of  its  constituent  vertebrae.  It  presents  the  fol- 
lowing points. — 

2  Cornua^  superiorly,  articulating  with  the  sacral  cornua 
to  form  foramina  for  the  5th  sacral  nerves. 

Apex,  is  sometimes  bifid  and  turned  to  one  side. 


Describe  the  Ossa  Innominata.  The  unnamed  bones  are  placed  one  on 
each  side  of  the  osseous  pelvis,  and  are  each  formed  by  the  union,  about 
puberty,  of  3  bones, — the  ilium,  ischium,  and  pubes.  The  innominate  bone 
as  a  whole  presents  the  following  points,  viz. — 

Acetabulum,  or  cotyloid  cavity,  receives  the  head  of  the  femur.     It  is  situ- 
ated at  the  junction  of  the  3  bones,  the  ilium  and  ischium  each  forming 
about  two-fifths,  and  the  pubes  one-fifth  of  it.     A  depression  in  its  centre 
lodges  a  mass  of  fat  containing  vessels  for  the  nourishment  of  the  synovial 
4* 


42  ANATOMY. 

membrane.  The  Cotyloid  Notch  is  a  deficiency  in  its  lower  anterioi 
margin,  transmitting  nutrient  vessels  to  the  joint ;  to  the  edges  of  the  notch 
is  attached  the  ligamentum  teres,  and  it  is  bridged  over  by  the  transverse 
ligament,  a  continuation  of  the  cotyloid  ligament  which  surmounts  the 
brim  of  the  acetabulum. 
Obturator^  or  Thyroid  Foramen^  on  the  anterior  surface  between  the  pubes 
and  ischium,  large  and  oval  in  the  male,  small  and  triangular  in  the 
female ;  is  closed  by  the  obturator  membrane,  except  above  where  the 
obturator  nerves  and  vessels  pass  through  it. 

Describe  the  Ilium.     It  is  the  superior  part  of  the  innominate  bone,  and 
presents  the  following  points,  viz. — 

Crest}  along  its  upper  border,  having  an  outer  and  inner  lip  for  muscular 
attachment,  and  ending  in  the  superior  spines. 

Anterior  Superior  Spine}   to  which  is  attached 
Fig-  22.  the  sartorius  and  tensor  vaginas  femoris  mus- 

cles, and  Poupart's  ligament. 
Anterior  Inferior  Spine}  for  the  straight  tendon 

of  the  rectus  femoris. 
Notch,  between  the  above-named    spines,  trans- 
mitting   the    external    cutaneous    nerve,   and 
lodging  some  fibres  of  the  sartorius. 
Posterior  Superior  Spine}^  for  the  attachment  of 
the  erector  spinse  muscle,  and  the  oblique  part 
of  the  sacro-sciatic  ligament. 
Posterior  Inferior  Spi?te}'^   for  the  great  sacro- 
sciatic  ligament. 
Great  Sacro-sciatic  Notch}^  below  the  last-named 
spine,  transmits  the  great  sciatic,  superior  gluteal,  and  pudic  nerves,  the 
pyriformis  muscle,  and  the  sciatic,  pudic,  and  gluteal  vessels,  and  a  nerve 
supplying  the  obturator  externus  muscle. 
Curved  Lines}^  superior  middle  and  inferior,  on  the  outer  surface  of  the 

bone,  from  the  spaces  between  which  arise  the  glutei  muscles. 
Groove,  above  the  acetabulum,  for  the  reflected  tendon  of  the  rectus  femoris 

muscle. 
Linea  Ilio-pectinea,  in  part ;  on  the  inner  surface,  above  which  is  a  smooth 

surface,  the   Venter  of  the  Ilium. 
Auricular  Surface}^  rough,  articulates  with  the  sacrum. 

Describe  the  Ischium.     It  is  the  lowermost  portion  of  the  innominate  bone, 
and  presents  the  following  points,  viz. — 

Body^  forms  two-fifths  of  the  acetabulum,  and  the  external  margin  of  the 


BONES    OF   THE   SHOULDER  43 

obturator  foramen ;  on  it  is  a  broad  groove  for  the  tendon  of  the  obturator 
externus  muscle.  Its  posterior  margin  assists  in  forming  the  great  sacro- 
sciatic  notch. 

Spine^^  for  the  gemellus  superior,  coccygeus,  and  levator  ani  muscles,  and 
the  lesser  sacro-sciatic  ligament. 

Lesser  Sacro-sciatic  Notch}^  below  the  spine,  transmits  the  obturator  muscle, 
its  nerve,  and  the  pudic  vessels  and  nerve  as  they  re-enter  the  pelvis,  hav- 
ing crossed  the  spine  of  the  ischium.  The  sacro-sciatic  notches  are  con- 
verted into  foramina  by  the  sacro-sciatic  ligaments;  the  greater  notch  by 
the  lesser  ligament,  the  lesser  notch  by  the  greater  ligament. 

Tuberosity}'^  the  lowest  and  most  prominent  part,  gives  attachment  to  the 
greater  sacro-sciatic  ligament,  and  to  several  muscles.  On  it  one  rests 
when  sitting. 

Ascending  Ramus,  bounds  the  obturator  foramen  inferiorly,  articulates  with 
the  descending  ramus  of  the  pubes,  and  gives  attachment  to  the  obturator 
membrane  and  several  muscles. 

Describe  the  Pubes.  The  pubic  or  pectineal  bone  forms  the  anterior  portion 
of  the  innominate.     It  presents  the  following,  viz. — 

Body,  lies  between  the  rami,  with  its  fellow  forms  the  Symphysis,  giving 

origin  to  several  muscles  and  ligaments. 
Crest,^  is  the  upper  part  of  the  body,  terminates  externally  in  the  Spine,  and 

internally  in  the  Angle. 
Spine,  affords  attachment  to  one  end  of  Poupart's  ligament. 
Linea  Iliopectinea,  in  part;  gives  attachment  to  the  conjoined  tendon,  Gim- 

bernat's  ligament,  and  the  triangular  ligament. 
Horizontal  Ramus,  forms  part  of  the  brim  of  the  pelvis,  of  the  margin  of  the 

obturator  foramen,  and  of  the  acetabulum.    On  its  under  surface  is  a  groove 

for  the  obturator  vessels  and  nerve. 
Pectineal  Eminence^  gives  attachment  to  the  psoas  parvus  muscle. 
Descending  Ramus}"^  flat  and  thin,  joins  the  ascending  ramus  of  the  ischium, 

and  bounds  the  obturator  foramen  internally. 

What  Muscles  are  attached  to  the  Os  Innominatum  ?  36,  comprising 
those  of  the  abdomen,  thigh,  perineum,  floor  of  the  pelvis,  and  rotators  of  the 
hip-joint. 

BONES  OF  THE  UPPER   EXTREMITY. 

THE    SHOULDER. 

What  Bones  form  the  Shoulder  ?  The  clavicle  and  scapula  connecting  the 
arm  with  the  trunk,  and  in  this  respect  homologous  to  the  innominate  bone  ia 
the  lower  part  of  the  body. 


44  ANATOMY. 

Describe  the  Clavicle.  The  collar-  or  key-bone,  is  a  short  bone  by  struct- 
ure, having  no  medullary  canal;  and  is  curved  like  the  letter  f,  its  inner 
two-thirds  being  cylindrical,  and  convex  anteriorly ;  its  outer  third  flattened, 
and  concave  anteriorly.  It  is  placed  horizontally  between  the  sternum  and 
the  scapula,  and  is  the  most  elastic  bone  in  the  body.  It  presents,  from  within 
outwards,  the  following  points,  viz. — 

Facets y  for  articulation  with  the  sternum  and  the  cartilage  of  the  ist  rib,  at 
its  sternal  end. 

Impression  for  the  rhomboid,  or  costo-clavicular  ligament. 

Groove,  on  the  lower  surface,  for  the  subclavius  muscle. 

Tubercle,  for  the  conoid  part  of  the  costo-clavicular  ligament. 

Oblique  Line,  for  the  trapezoid  part  of  the  same  ligament. 

Facety  on  the  acromial  end,  for  articulation  with  the  scapula. 

Nutrient  Foramen,  in  the  subclavian  groove. 

Describe  the  Scapula.  The  shoulder-blade  is  a  large,  flat,  and  triangular 
bone,  situated  on  the  posterior  and  lateral  portion  of  the  thorax,  from  the  2d 
rib  to  the  7th,  inclusive. 

The  Venter,  or  anterior  surface,  presents  from  within  outwards, — 
Ridges,  giving  attachment  to  the  subscapularis  muscle. 
Marginal  Surface,  along  the  inner  border,  for  the  attachment  of  the  serratus 

magnus  muscle. 
Subscapular  Fossa,  and  Angle,  for  the  subscapularis  muscle. 
The  Dorsum,  or  posterior  surface,  presents  the  following,  viz. — 

Spine,  a  bony  ridge,  which  affords  attachment  to  the  trapezius  and  deltoid 

muscles,  and  ends  in  the  acromion  process. 
Supraspinous  Fossa,  above  the  spine,  for  the  supraspinatus  muscle. 
Infraspinous  Fossa,  below  the  spine,  larger  than  the  supraspinous,  convex  at 

its  centre,  lodges  the  infraspinatus  muscle,  and  the  nutrient  foramen. 
Marginal  Surface,  along  the  external  border,  to  which  are  attached  the  teres 
minor  muscle  above,  the  teres  major  below,  and  sometimes  a  few  fibres  of 
the  latissimus  dorsi  at  the  lower  angle. 
Groove  crossing  the  margin,  for  the  dorsalis  scapulae  vessels. 
Smooth  Surface,  behind  the  root  of  the  spine,  over  which  the  trapezius 
muscle  glides. 
The  Acromion  process,  or  "  summit  of  the  shoulder,"  extends  from  the  spine, 
and  projects  over  the  glenoid  cavity,  articulating  with  the  clavicle  by  an  oval 
facet.     It  affords  attachment  to  the  deltoid  and  trapezius  muscles,  and  by  its 
apex  to  the  coraco-acromial  ligament. 
The  Coracoid  process,  or  "  crow's  beak,"  projects  from  the  upper  border 
and  neck  of  the  bone  over  the  inner  and  upper  part  of  the  glenoid  cavity. 


BONES   OF   THE   ARM.  45 

Into  it  is  inserted   i   muscle,  the  pectoralis  minor;   the  coraco-brachialis, 
and  the  short  head  of  the  biceps  arise  from  it  by  a  common  tendon  ;  and  3 
ligaments  are  attached  to  it, — the  conoid,  trapezoid,  and  coraco-acromial. 
The  Superior  Border  presents  the — 

Suprascapular  Notch,  converted  into  a  foramen  for  the  suprascapular  nerve 

by  the  transverse  ligament,  over  which  passes  the  suprascapular  artery. 

The  omo-hyoid  muscle   is   attached   to  the  border  just  internal  to  the 

notch. 
The  Axillary  Border  is  the  thickest,  and  presents  a — 

Rough  Surface,  for  the  long  head  of  the  triceps  muscle,  just  below   the 

glenoid  cavity. 
Groove,  the  origin  of  a  part  of  the  subscapularis  muscle. 
The  Vertebral  Border  is  the  longest,  and  presents  an — 
Anterior  Lip,  for  the  attachment  of  the  serratus  magnus. 
Posterior  Lip,  for  the  supra-  and  infra-spinatus  muscles. 
Interspace,  between  the  lips,  for  the  levator  anguli  scapulae,  the  rhomboideus 

minor,  and  the  fibrous  arch  of  the  rhomboideus  major  muscles. 
Other  points  of  interest  on  the  bone  are  the — 

Superior  Angle,  aflTords  attachment  to  part  of  the  serratus  magnus,  levator 

anguli  scapulae,  and  supra-spinatus  muscles. 
Inferior  Angle,    affords    attachment   to   part   of  the  serratus   magnus   and 

teres  major  muscles,  and  occasionally  to  a  few   fibres  of  the  latissimus 

dorsi. 
Glenoid   Cavity,  at  the  external  angle   or  head  of   the   bone,    a   shallow 

cavity  for  the  reception  of  the  head  of  the  humerus.     It  is  deepened  by 

the  glenoid  ligament   which  is  attached  around   its  margin ;  and  at  its 

upper  part  gives   origin   to   the  long   head  of  the   biceps   flexor   cubiti 

muscle. 
Neck,  is  the  contracted  part  of  the  bone  behind  the  glenoid  cavity ;  from 

it  arises  the  anterior  root  of  the  coracoid  process. 

THE  ARM. 

Describe  the  Humerus.  It  is  the  only  bone  in  the  arm,  and  articulates 
with  the  scapula  above,  and  with  the  ulna  and  radius  below.  It  presents  the 
toUowing  points,  viz. — 

Head,b  is   nearly   hemispherical,  and   smooth   for   articulation  with  a  gle- 
noid cavity  of  the  scapula. 
Anatomical  Neck,c  is  a  constriction  in  the  bone,  just  below  the  head,  for  the 

attachment  of  the  capsular  ligament. 
Greater    Tuberosity,^  has  3  small    facets    for   the    insertions   of  the  supra- 
spinatus,  infraspinatus,  and  teres  minor  muscles. 


46 


ANATOMY. 


Fig.  23. 


Lesser  Tuberosity,'  on  the  inner  side  of  the  bone,  gives  insertion  to  the 

subscapularis  muscle. 
Bicipital  Groove,/  lies  vertically  between  the  tuberosities  for  the  upper  third 
of  the  bone,  and  lodges  the  tendon  of  the  long  head  of  the  biceps  flexor 
cubiti.  Into  its  inner  or  posterior  lip  h  are  inserted  the  teres  major  and 
latissimus  dorsi  muscles,  while  its  outer  or  anterior  lip^  receives  the  in- 
sertion of  the  tendon  of  the  pectoralis  major,  which  covers  the  groove. 

Surgical  Neck,  is  situated  immediately  below  the  tuberosi- 
ties, and  is  a  slight  constriction  in  the  upper  part  of  the 
shaft. 
Shaft,^  is  cylindrical  above,  prismatic  and  flattened  below. 

Rough  Surfaccyi  for  the  insertion  of  the  deltoid,  muscle, 
about  the  middle  of  the  external  surface  of  the  shaft. 

Musculo-spiral  Groove,  lodging  the  musculo-spiral  nerve, 
and  the  superior  profunda  artery,  is  situated  on  the  pos- 
terior surface  of  the  shaft,  separating  the  origins  of  the 
outer  and  inner  heads  of  the  triceps  muscle. 
?||fl,  Orifice  J  of  the   nutrient   canal,  about  the  middle   of  the 

shaft. 
Condyloid  Ridges  op  internal    and    external,   arising   from 
the  respective  condyles,  extending  upwards  along  the 
shaft. 
External    Condyle,"^    gives    attachment    to    the    external 
lateral  ligament  and    the  extensor  and  supinator  group 
of  muscles. 
Internal  Condyle,^  lower  and  more  prominent  than  the 
other,  gives  attachment  to  the  internal  lateral  ligament 
and   the  flexor  and   pronator  group  of  muscles  of  the 
fore-arm. 
Radial  Head,k  forms  the  external  part  of  the  inferior  articular  surface ;  for 

articulation  with  the  radius. 
Trochlear  Suifiace,l  articulates  with  the  greater  sigmoid  cavity  of  the  ulna ; 
is  a  deep  depression  between  two  borders,  and  extends  from  the  anterior 
to  the  posterior  surface  of  the  bone. 
Coronoid  Fossa,<J  in  front  of  the  trochlea,  receives  the  coronoid  process  of 

the  ulna  when  the  fore-arm  is  flexed. 
Olecranon  Fossa,  behind  the  trochlea,  receives  the  tip  of  the  olecranon  pro- 
cess,  when  the  fore-arm  is  extended. 


BONES  OP  THE   FORE-ARM. 


47 


THE   FORE-ARM. 

Describe  the  Ulna.  The  elbow-bone  is  the  internal  bone  of  the  fore-arm. 
It  is  larger  and  longer  than  the  radius,  forming  the  greater  portion  of  the 
articulation  with  the  humerus.  It  does  not  enter  into  the  formation  of  the 
wrist-joint,  being  excluded  therefrom  by  an  interarticular  fibro-cartilage.  It 
presents  the  following,  viz. — 

Olecranon  Processed  at  the  upper  extremity,  forming  the  elbow.  It  is  curved 
forwards,  its  apex  being  received  into  the  olecranon  fossa  of  the  humerus 
when  the  fore  arm  is  extended.  Its  posterior  surface  gives  insertion  to  the 
tendon  of  the  triceps.    In  its  function  and  structure  it  resembles  the  patella. 

Coronoid  Process,e  below  the  olecranon,  projects  forwards,  its  apex  being 
received  into  the  coronoid  fossa  of  the  humerus  when  the  fore-arm  is 
flexed.  Its  upper  surface  is  concave  for  articulation  with  the  humerus, 
its  lower  surface  rough  for  the  insertion  of  the  brachialis  anticus  muscle. 
Its  inner  surface  has  a  margin  for  the  internal  lateral  ligament,  a  tubercle 
for  the  flexor  sublimis  digitorum,  and  a  ridge  for  the  pronator  radii  teres. 

Greater  Sigmoid  Cavity J^  lies  between  the  processes,  and  is  divided  by  a 
vertical  ridge  into  two  unequal  parts.     It  articulates  with  the  trochlear 


surface  of  the  humerus. 

Lesser  Sigmoid  Cavity  c  lies  external  to  the  coronoid 
process ;  is  oval  and  concave,  articulating  with  the 
head  of  the  radius,  and  giving  attachment  to  the 
orbicular  ligament. 

Shaft  a  large  and  prismatic  above,  smaller  and  rounded 
below,  has  the  Nutrient  Foramen/ on  its  anterior  sur- 
face, and  a  prominent  margins  externally,  to  which 
is  attached  the  interosseous  membrane.  The  shaft 
gives  attachment  to  9  of  the  12  muscles  of  the  fore- 
arm. 

Headh  at  the  carpal  end,  articulates  with  the  lesser 
sigmoid  cavity  of  the  radius,  and  the  fibro-cartilage 
of  the  wrist-joint. 

Styloid  FrocesSyi  projecting  from  the  head  internally 
and  posteriorly,  its  apex  gives  attachment  to  the  in- 
ternal lateral  ligament,  and  a  depression  at  its  root 
to  the  fibro-cartilage  of  the  joint. 

Groove,  for  the  tendon  of  the  extensor  carpi  ulnaris 
muscle. 


Fig.  24. 


48 


ANATOMY. 


Describe  the  Radius.  The  radius  lies  externally  to  the  ulna  when  the 
fore -arm  is  in  supination  ;  it  is  prismatic  in  form  with  the  base  below  where  it 
articulates  with  the  carpus.  The  bone  is  curved  outwards  and  is  shorter  than 
the  ulna,  by  the  length  of  the  olecranon.  It  presents  the  following  points  from 
above  downwards,  viz. — 

Head,k  cylindrical  and  cup-shaped,  articulating  with  the  radial  head  of  the 
humerus,  and  the  lesser  sigmoid  cavity  of  the  ulna,  and  playing  within 
the  orbicular  ligament. 

Neck,l  the  constricted  part  below  the  head. 

Tuberosity,^  rough  behind  for  the  insertion  of  the  biceps,  and  smooth  in 
front  where  it  is  covered  by  a  bursa. 

Shaft,j  prismoid  in  form,  presents  a  sharp  border  internally  for  the  attach- 
ment of  the  interosseous  membrane;  the  Nutrient  Foramen  is  on  its  an- 
terior surface.     It  gives  attachment  to  8  of  the  12  muscles  of  the  fore-arm. 

Sigmoid  Cavity,  at  the  internal  side  of  the  carpal  end,  is  shallow,  and  artic- 
ulates with  the  head  of  the  ulna. 

Articular  Surface  o  is  divided  by  a  ridge  into  2  facets  for  articulation  with 
the  semilunar  and  scaphoid  bones  of  the  carpus. 

Styloid  Process, P  externally,  gives  attachment  by  its  apex  to  the  external 
lateral  ligament,  and  by  its  base  to  the  supinator  longus  muscle. 

Grooves,  on  the  posterior  and  external  surfaces  of  the  lower  extremity,  for 
the  tendons  of  the  8  extensor  muscles  of  the  thumb,  and  those  of  the 
radial  side  of  the  wrist,  and  fingers. 

THE   HAND. 
How  are  the  Bones  of  the  Hand  divided  ?     Into  the  carpus  (8),  the  meta- 
FiG.  25.  carpus  (5),  and  the  phalanges  (14).     Total, 

27  bones. 

Name  the  Bones  of  the  Carpus.  They 
are  placed  in  2  rows,  one  row  in  front  of  the 
other,  with  4  bones  in  each  row,  as  follows, 
— the  left  hand  being  in  supination,  naming 
from  without  inwards,  viz. — 

ist,  or  Proximal  Pow, — Scaphoid,^  Semi- 
lunar,^ Cuneiform,  C  Pisiform. -^ 
2d,  or  Distal  Row, — Trapezium,^  Trape- 
zoid, 7"  Os-magnum,-^  Unciform.^ 
State  the  number  of  Articulations  in  the 
Carpus.     34,  as  follows, — the  number  after 
each   bone  representing   the  number  of  its 
articulations,  viz. — 


BONES   OF  THE  HAND.  49 

Scaphoid,  5.         Semilunar,  5.       Cuneiform,  3.         Pisiform,  i. 
Trapezium,  4.      Trapezoid,  4.       Os-magnum,  7.       Unciform,  5. 

What  peculiarities  have  the  Carpal  bones  ?  The  first  three  enter  into  the 
formation  of  the  wrist-joint ;  the  pisiform  does  not,  but  is  wholly  without  it, 
and  may  be  considered  a  mere  appendage  of  the  carpus.  When  the  hand  is 
in  pronation — 

The  Scaphoid,  or  boat-shaped  bone,  has  a  tuberosity  on  its  outer  side,  its 

largest  auricular  facet  is  uppermost,  and  a  transverse  groove  crosses  its 

posterior  surface. 
The  Semilunar  Bone  has  a  crescentic  facet  externally,  and  a  convex  facet 

superiorly. 
The  Cuneiform  Bone  is  wedge-shaped,  its  convex  surface  above,  and  has  an 

isolated  facet  for  the  pisiform  articulation. 
The  Pisiform  Bone  is  the  smallest,  and  has  but  one  facet,  which  lies  poste- 
riorly when  the  bone  is  in  position. 
The  Trapezium  has  a  deep  groove  for  the  tendon  of  the  flexor  carpi  radialis, 

and  a  saddle-shaped  facet,  inferiorly. 
The  Trapezoid  is  small  and  quadrilateral,  bent  on  itself,  with  a  saddle-shaped 

facet  looking  downwards. 
The  Os-magnum  has  a  head  looking  upwards,  a  neck,  and  a  body;  is  the 

largest  bone  of  the  carpus,  and  has  a  tubercle  on  the  inner  side  of  the  base. 
The  Unciform  Bone  is  triangular,  with  a  concavity  which  lies  to  the  outer 

side;  and  the  unciform  process,  long  and  curved,  projecting  from  its  palmar 

surface. 

Describe  the  Metacarpus.  The  5  metacarpal  bones  are  placed  between  the 
carpus  and  the  phalanges,  are  long  bones,  and  each  has  a  head,  shaft,  and 
base.     Their  heads  articulate  with  the  respective  phalanges, 

ist  Metacarpal  Bone,d  articulates  with  the  trapezium,  is  shorter  than  the 
others  by  one-third,  and  its  base  has  but  i  articular  facet.  This  bone  is 
classed  among  the  phalanges  by  Professor  W.  H,  Pancoast. 

2d  Metacarpal  Bone/  articulates  with  3  bones  of  the  carpus, — the  trape- 
zium, trapezoid,  and  os-magnum ;  its  base  is  large,  and  has  4  articular  facets, 

jd  Metacarpal  Bone^^  articulates  with  i  bone  of  the  carpus, — the  os-mag- 
num ;  its  base  has  a  projecting  process  on  the  radial  side,  and  2  small 
facets  on  the  opposite  side. 

4th  Metacarpal  Bone^g  articulates  with  2  bones  of  the  carpus  and  with  the 
adjacent  metacarpal  bones;  its  base  is  small,  and  has  2  circular  facets,  i 
on  each  side. 

^th  Metacarpal  Bone,h  articulates  with  I  carpal   bone, — the  unciform;  its 
base  has  i  lateral  articular  facet. 
6  D 


60 


ANATOMY. 


Describe  the  Phalanges.  The  finger-bones  are  14  in  number  (15  accor«. 
ing  to  Pancoast),  3  to  each  finger,  and  2  to  the  thumb.  They  are  long  bones, 
and  each  has  a  base,  a  shaft,  and  a  digital  extremity.  The  Bases  of  the  first 
row  articulate  with  the  heads  of  the  metacarpal  bones.  The  Digital  Extremities 
of  the  first  and  second  rows  have  each  2  small  lateral  condyles,  while  in  the 
terminal  row  they  are  rough,  for  the  attachment  of  the  sensitive  pulp  of  the 
fingers. 

BONES   OF   THE   LOWER   EXTREMITY. 
THE   THIGH. 
Describe  the  Femur.      The  thigh-bone  is  nearly  cylindrical,  and  is  the 
longest,  largest,  and  strongest  bone  in  the  body.    In  the  ver- 
^  tical  position  of  the  skeleton  it  forms  one  side  of  a  triangle, 

of  which  the  base  is  the  breadth  of  the  pelvis,  and  the  apex 
at  the  knee-joints.    The  base  of  this  triangle  is  longest  in  the 
female,  and  consequently  that  sex  is  usually  knock-kneed. 
Head,b  articulates  with  the  acetabulum,  forms  about  two- 
fifths  of  a  sphere,  and  has  an  oval  depressions  below  its 
centre  for  the  attachment  of  the  ligamentum  teres. 
Neck,c  connects  the  head  with  the  shaft,  is  pyramidal  and 
flattened ;  its  obliquity  varies  with  age,  being  less  before 
puberty,  about  120  to  125  degrees  in  the  adult,  and  nearly 
horizontal  to  the  shaft  in  old  or  debilitated  subjects. 
Great  Trochanter  d  a  broad,  rough,  quadrilateral  process 
directed  outwards  and  backwards  from  the  summit  of 
the  shaft  to  within  three-fourths  of  an  inch  of  the  level 
of  the  head.     On  its  outer  surface  the  tendon  of  the 
gluteus  maximus  plays  over  a  bursa.     It  gives  insertioji 
to  the  obturator  internus,  two  gemelli,  pyriformis,  and 
gluteus  minimus  and  medius  muscles. 
Digital  Fossa,  on  the  inner  surface  of  the  great  trochantei, 

gives  insertion  to  the  obturator  externus  muscle. 
Lesser  Trochanter, e  at  the  inferior  root  of  the  neck  pos- 
teriorly, is  small  and  conical,  and  affords  insertion  to  the 
tendon  of  the  psoas  magnus  muscle,  the  tendon  of  the 
iliacus  being  inserted  immediately  below  it. 
Inter-trochanteric  Lines,  anterior  and  posterior,  the  latter  the  most  prominent ; 

to  the  anterior  is  attached  the  capsular  ligament  of  the  hip-joint. 
Linea  Quadrati,  extends  from  the  middle  of  the  posterior  inter-trochanteric 
line  about  2  inches  down  the  shaft,  and  gives  attachment  to  the  quadratus 
fsBuniis  muscle. 


BONES   OF  THE  LEG.  61 

Shafty  is  slightly  curved  forwards,  broad  and  cylindrical  at  each  end,  and 
narrow  and  triangular  in  the  centre.  Its  nutrient  foramen  perforates  its 
posterior  surface  below  the  centre.  From  its  anterior  surface  arise  th« 
crureus  and  sub-crureus  muscles. 

Linea  Aspera,gs  a  crest  lying  along  the  central  third  of  the  shaft  posteriorly; 
bifurcating  above  towards  each  trochanter,  also  below  towards  the  2  con- 
dyles. To  its  outer  lip  is  attached  the  vastus  externus,  to  its  inner  lip,  the 
vastus  internus ;  and  between  them,  the  pectineus,  adductor  brevis,  and 
gluteus  maximus  above  the  short  head  of  the  biceps  below,  and  the  ad- 
ductors longus  and  magnus  along  the  greater  portion  of  the  space. 

Groove^  crossing  the  internal  condyloid  ridge,  and  lodging  the  femoral  artery. 

Popliteal  Space  J^  triangular  and  smooth,  lying  between  the  condyloid  ridges, 
for  the  popliteal  artery. 

External  Condyle.i  broader  and  shorter  than  the  internal,  so  as  to  form  a 
horizontal  articulation,  the  bone  being  inclined  towards  the  median  line. 
It  gives  attachment  to  the  external  lateral  ligament,  and  the  popliteus  and 
gastrocnemius  muscles. 

Internal  Condyle,t  the  longest  by  half  an  inch;  it  gives  attachment  to  the 
internal  lateral  ligament  and  the  gastrocnemius  muscle. 

Inter-condyloid  Notch  k  lodges  the  crucial  ligaments.  In  front  the  condyles 
are  continuous  with  each  other,  forming  a  concave  depression  or  trochlea 
for  the  patella. 

Outer  Tuberosity,  on  the  external  condyle,  for  the  attachment  of  the  exter- 
nal lateral  ligament. 

Groove,  below  the  outer  tuberosity,  for  the  tendon  of  the  popliteus  nvuscle, 
terminating  in  a  depression  whence  the  muscle  takes  its  origin. 

Inner  Tuberosity,  on  the  internal  condyle,  for  the  attachment  of  the  internal 
lateral  ligament. 

Tubercle,  above  the  inner  tuberosity,  for  the  insertion  of  the  tendon  of  thw 
adductor  magnus  muscle. 

Depression,  behind  the  tubercle,  for  the  tendon  of  the  inner  head  of  thf 
gastrocnemius. 

THE   LEG. 

Describe  the  Tibia.  The  shin-bone  ranks  next  to  the  femur  in  respect  to 
fize  and  length.  Its  form  is  prismoidal,  the  upper  extremity  being  much  larger 
than  the  lower. 

Head,  expands  into  2  lateral  tuberosities,^<^  which  articulate  with  the  con- 
dyles of  the  femur. 
Spine,d  projects  vertically  between  the  2  articular  surfaces,  is  bifid,  affording 
attachment  to  the  semilunar  fibro-cartilages,  and  by  depressions  in  front 
and  behind  its  base  to  the  crucial  ligaments  of  the  joint. 


62 


ANATOMY. 


Tuberde,e  anteriorly  on  the  head,  between  the  tuberosities,  for  the  insertioM 

of  the  ligamentum  patellae. 
Popliteal  Notch,  posteriorly  between  the  tuberosities,  affords  attachment  to 

the  posterior  crucial  ligament. 
Groove,  on  the  inner  tuberosity  posteriorly,  for  the  insertion  of  the  tendon  of 
the  semi-membranosus  muscle. 

Facet,  on  the  outer  tuberosity  posteriorly  and  looking 
^7-  downwards,  for  articulation  with   the   head  of  the 

fibula. 
Popliteal  Line,  obliquely  across  the  upper  part  of  the 
shaft  posteriorly,  affords  attachment  to  the  fascia  of 
the  popliteus,  and  parts  of  the  soleus,  flexor  longus 
digitorum,  and  tibialis  posticus  muscles. 
Nutrient  Canal,  the  largest  in  the  skeleton,  opens  just 

below  the  popliteal  line,  its  orifice  looking  upwards. 
Shaft, a.  has  3  sharp  ridges, — I    in  front,  the  Crest  or 
Shin,/  and  i  on  either  side,  to  the  external  of  which 
is  attached  the  interosseous  membrane. 
Lower  Extremity, g  is  smaller  than  the  upper,  grooved 
posteriorly  for  the  tendon  of  the  flexor  longus  pol- 
licis ;    externally  has  a  rough  triangular  depression 
for  articulation  with  the  fibula,  and  for  the  attach- 
ment of  the  inferior  interosseous  ligament.     Its  in- 
ferior surface  is  concave  and  smooth  for  articulation 
with  the  upper  surface  of  the  astragalus. 
Internal  Malleolus,^  projects  downwards  from  the  in- 
ternal side  of  the   lower  extremity.     It  articulates 
with  the  astragalus,  is   grooved   posteriorly  for   the 
tendons  of  the  tibialis   posticus   and   flexor   longus 
digitorum  muscles,  and  affords  attachment  to  the  in- 
ternal lateral  ligament. 
Describe  the  Fibula.     It  is  a  long  slender  bone,  placed  nearly  parallel 
with  the  tibia  on  the  outer  side  of  the  leg.     It  is  also  called  the  peroneous,  or 
peroneal  bone. 

Head,J  articulates  with  the  external  tuberosity  of  the  tibia  by  a  flat  facet. 
Externally  it  has  a  prominence  for  the  attachment  of  the  long  external 
lateral  ligament  of  the  knee-joint. 
Styloid  Process,  projects  upwards  from  the  head  posteriorly,  and  gives  inser- 
tion to  the  tendon  of  the  biceps  muscle,  and  the  short  external  lateral 
ligament  of  the  knee-joint. 
Shaft  i  is  triangular  and  twisted  on  itself,  having  3  marked  ridges,  the 


BONES   OF  THE   FOOT. 


53 


innermost  of  which  is  sharp  for  the  attachment  of  the  interosseus  mem- 
brane. The  shaft  arches  backwards,  and  gives  attachment  to  8  of  the  12 
muscles  of  the  leg. 

Nutrient  Canal,  opens  about  the  centre  of  the  shaft  posteriorly,  its  orifice 
looking  downwards. 

External  Malleolus,^  is  the  lower  extremity  of  the  bone.  It  is  larger  and 
longer  than  the  internal,  articulates  with  the  astragalus  by  a  triangular 
facet,  and  is  grooved  posteriorly  for  the  tendons  of  the  peroneus  longus 
and  brevis  muscles.  Its  edge  affords  attachment  to  the  external  lateral 
ligament  of  the  ankle-joint. 


THE   FOOT. 

How  are  the  bones   of  the   Foot   divided?     Into  the   tarsus  (7),  meta- 
tarsus (5),  and  phalanges  (14).     Total,  26  bones- 
Name  the  bones  of  the  Tarsus.     They  are  placed  in  2  rows  side  by  side, 
2  bones  in  the  external  row,  5  in  the  internal,  as  follows-  viz. — 
Internally, —       Astragalus.^  Scaphoid,^  3  Cuneiform.?/^ 

Externally, —     Os  calcis.*^  Cuboid.'^ 

How  many  Articulations  are  in  the  Tarsus  ?     28,  each  bone  articulating 
with  4  others,  except  the  os  calcis,  which  articulates 
with  2,  and  the  external  cuneiform  with  6  bones. 

What  Peculiarities  have  the  Tarsal  Bones  ? 
They  may  be  divided  transversely  at  the  astragalo- 
scaphoid-calcaneo-cuboid  articulation,  the  site  of 
Chopart's  operation. 

The  Astragalus,^  has  a  rounded  head,  a  convex 
surface  on  which  is  a  broad  articular  facet,  and 
on  its  inferior  surface  a  deep  groove  between 
2  articular  facets. 
The  Os  Calcis,c  is  a  large  bone,  having  on  its  upper 
surface  a  deep  groove  for  the  interosseous  liga- 
ment, between  2  articular  surfaces;  anteriorly 
a  large  irregular  portion,  the  head;  and  pos- 
teriorly an  elongated  portion  forming  the  Heel. 
On  its  internal  surface  is  a  projection,  the  Susten- 
taculum Tali,  which  supports  the  internal  articu- 
lating surface  ;  below  which  process  the  bone  is 
deeply  grooved  for  the  plantar  vessels  and  nerves 
and  the  flexor  tendons.  To  the  os  calcis  are  at- 
tached 8  muscles  and  the  plantar  fascia. 
6* 


64  ANATOMY. 

Thi  Scaphoid  Bone^d  \%  boat-shaped,  has  3  facets  anteriorly  for  the  cunct 
form  bones,  a  concave  surface  posteriorly  for  the  astragalus,  and  a  facel 
externally  for  the  cuboid  bone.  A  tubercle  is  situated  on  the  lower  sur- 
face internally,  for  the  insertioji  of  the  tibialis  posticus  muscle. 

llie  Cuboid  Bone, ft-  has  3  articular  surfaces,  and  a  groove  inferiorly  for  the 
tendon  of  the  peroneus  longus. 

The  Internal  Cuneiform  Bd*ie,e  the  largest  of  the  3,  has  a  tubercle  on  its 
plantar  surface  for  the  insertion  of  parts  of  the  tendons  of  the  tibialis 
anticus  and  tibialis  posticus  muscles. 

The  Middle  Cuneiform  Bone,/  is  small  and  wedge-shaped  with  the  narrow 
end  downwards.  Its  anterior  surface  is  considerably  behind  the  line  of 
the  tarso-metatarsal  articulation,  thus  forming  a  recess  into  which  the  base 
of  the  second  metatarsal  bone  fits. 

The  External  Cuneiform  Bone,g  is  also  wedge-shaped,  but  longer  than  the 
middle  one ;  and  affords  origin  to  I  muscle,  the  flexor  brevis  pollicis. 

Describe  the  Metatarsus.  The  metatarsal  bones  i  are  5  in  number,  are 
long  bones,  having  each  a  shaft  and  2  extremities.  Their  bases  articulate 
with  the  tarsal  bones  and  with  each  other ;  their  heads  with  the  first  row  of 
phalanges. 

ist  Metatarsal,  is  large  but  shorter  than  the   others,  and  forms  the   inner 

border  of  the  foot,  articulating  with  the  internal  cuneiform. 
2d  Metatarsal,  is  the  longest ;  its  base  has  3  facets  for  articulation  with  the 
3  cuneiform  bones  in  the  recess  formed  by  the  shortness  of  the  middle 
cuneiform. 
^d  Metatarsal,  has  2  facets  on  the  inner  side  of  its  base,  besides  the  facets 

for  the  internal  cuneiform  and  the  4th  metatarsal  bone. 
4th  Metatarsal,  articulates  with  the  cuboid  bone,  and  also  with  the  internal 

cuneiform. 
^th  Metatarsal,  articulates  obliquely  with  the  cuboid  bone,  and  has  a  tuber- 
cular projection  on  the  outer  surface  of  its  base,  which  forms  the  guide  to 
Hey's  operation. 

Describe  the  Phalanges  of  the  Foot.  They  number  14  as  in  the  hand, 
the  great  toe  having  2,  the  other  toes  3  each.  They  are  long  bones,  each 
having  a  base,  a  shaft,  and  an  anterior  extremity.  They  are  convex  above, 
concave  below,  and  articulate  by  the  bases  of  the  first  row  with  the 
bones  of  the  metatarsus.  The  anterior  extremities  of  the  distal  phalanges^,« 
are  expanded  into  surfaces  for  the  support  of  the  nails  and  pulp  of  the 
toes. 


THE  ARTICULATIONS.  St 

THE   ARTICULATIONS. 

Into  what  Classes  are  the  Articulations  divided?  Into  3, — i.  Synarthro' sis^ 
immovable;  2.  Amphiarthro^ sis.  Synchondrosis,  or  Symphysis,  having  limited 
motion;  3,  Diarthro^sis,  having  free  motion. 

How  are  the  Synarthroses  subdivided?  Into  3  divisions, — Sutura,  by 
indentations;  Schindy^lesis,  by  a  plate  of  bone  into  a  cleft  in  another;  and 
Gompho'sis,  by  a  conical  process  into  a  socket.  The  Sutura  are  again  sub- 
divided into — S.  Dentata,  having  tooth-like  processes;  S.  Serrata,  with  ser- 
rated edges;  S.  Limbosa,  having  beveled  margins  and  dentated  processes;  S. 
Squamosa,  with  thin  beveled  margins  overlapping  each  other;  S.  Harmonia, 
contiguous  rough  surfaces  opposed  to  each  other.  The  first  3  are  also  named 
Sutura  Vera  (true  sutures)  having  indented  borders ;  the  last  2  Sutura  Notha 
(false  sutures)  being  formed  by  rough  surfaces. 

How  are  the  Diarthroses  divided  ?  Into  4  divisions, — Arthrodia,  gliding 
joint;  jE'«<3:r//^r(3j-2>,  ball-and-socket  joint ;  Ginglymus,\i\xi^<t-]o\Xi'i',  and  Diar* 
throsis  Rotatorius,  a  ring  surrounding  a  pivot. 

Give  an  Example  of  each  of  the  above-named  articulations. 
Synarthro^sis, — bones  of  cranium  and  face,  except  the  lower  jaw. 

Sutura  Dentata, — the  inter-parietal  suture. 

Sutura  Serrata, — the  inter-frontal  suture. 

Sutura  Limbosa, — the  fronto-parietal  suture. 

Sutura  Squamosa, — the  tempora-parietal  suture. 

Sutura  Harmonia, — the  intermaxillary  symphysis. 

Schindylesis, — rostrum  of  sphenoid  with  the  vomer. 

Gompho^sis, — the  teeth  in  their  alveoli. 
4mphiarthro'sis, — the  bodies  of  the  vertebrge,  the  sacro-iliac,  and  pubic  $ym« 

physes. 
Piarthro'ses,— 

Arthrodia, — sterno-clavicular  articulation. 

Enarthrosis, — hip-joint,  shoulder-joint. 

Ginglymus, — elbow-joint,  ankle-joint,  knee-joint. 

Diarthrosis  Rotatorius, — the  superior  radio-ulnar,  and  atlo-axoid  articula- 
tions. 

Name  the  Varieties  of  motion  in  joints  ?  There  are  7  varieties,  viz. — 
flexion,  extension,  adduction,  abduction,  rotation,  circumduction,  and  gliding 
movement. 

What  Structures  enter  into  the  formation  of  joints?  There  are  5,  viz.— 
\he  articular  lamella  of  bone,  ligaments,  cartilage,  fibro-cartilage^  and  synovial 
«embrane. 


ANATOMY. 


Articular  Lamella  of  bone  differs  from  ordinary  bone  tissue  in  being  more 
dense,  containing  no  Haversian  canals  nor  canaliculi,  and  having  largei 
lacunae. 

Ligaments  are  bands  of  white  fibrous  tissue,  except  the  ligamentum  sub- 
fiava  and  the  ligamentum  nuchae,  which  are  both  composed  purely  of 
yellow  elastic  tissue. 

Cartilage  is  temporary  or  permanent.  The  first  forms  the  original  frame- 
work of  the  skeleton,  and  becomes  ossified.  Permanent  cartilage  is  not 
prone  to  ossification,  and  is  divided  into  3  varieties, — Articular,  covering 
the  ends  of  bones  in  joints;  Costal,  forming  part  of  the  skeleton ;  Reticular, 
arranged  in  lamellae  or  plates  to  maintain  the  shape  of  certain  parts. 

Fibro-cartilage  is  Interarticular  (menisci),  separating  the  bones  of  a  joint ; 
Connecting,  binding  bones  together;  Circumferential,  deepening  cavities; 
Stratiform,  lining  grooves. 

Synovial  Membranes  secrete  the  synovia,  a  viscid,  glairy  fluid,  and  resemble 
the  serous  membranes  in  structure.  They  are  Articular,  lubricating  joints  \ 
Bursal,  forming  closed  sacs  (bursae)  ;    Vagineu.^  ensheathing  tendons. 

Describe  the  Vertebral  Articulations.  They  are  formed  by  the  adjacent 
Burfaces  of  the  bodies  of  the  vertebrae,  and  their  articular  processes,  and  are 
connected  by  the  following  ligaments,  etc. — (See  FiG.  31.) 

Lntervertebral  Fibro-cartilages,  between  the  bodies  of  all  true  vertebrae,  ex- 
cept the  axis  and  atlas. 
Anterior  Common  Ligament}  along  fronts  of  the  bodies. 
Posterior  Common  Ligament,  along  backs  of  the  bodies. 
Ligamenta  Subflava,  connect  the  laminae  of  adjacent  vertebrae. 
Capsular,^  surround  the  articular  processes,  and  are  lined  by  synovial  mem- 
brane. 
Supraspinous  and  Inter-spinous,  connect  the  spinous  processes. 
Inter-transverse^  connect  the  transverse  processes. 

Describe  the  Occipito-atloi4  Articulation.     It  is  a  double  arthrodia  formed 

by  the  condyles  of  the  occipital  bone 
with  the  superior  articular  surfaces  of  the 
atlas,  and  has  7  ligaments,  viz. — 
2  Anterior  Occipito-atloid,^^  from  the  an- 
terior margin  of  the  foramen  magnum 
to  the  anterior  arch  of  the  atlas. 
Posterior  Occipito-atloid,  from  the  posterior 
margin  of  the  foramen  magnum  to  the 
posterior  arch  of  the  atlas.  It  is  per- 
forated by  the  vertebral  arteries  and  sub 
occipital  nerves. 


Fig. 


THE   ARTICUI-ATIONS.  57 

3  Lateral,  from  the  jugular  processes  of  the  occipital  bone  to  the  bases  of  the 

transverse  processes  of  the  atlas. 
2  Capsular.d  around  the  articular  surfaces,  lined  by  synovial  membrane. 

Describe  the  Occipito-axoid  Articulation.  Formed  by  the  occipital  bone 
and  the  odontoid  process  of  the  axis,  which  do  not  articulate  with  each  other 
strictly,  but  are  connected  by  4  ligaments. 

Occipito-axoid^  {Apparatus  Ligamentosus  Colli),  a  continuation  of  the  posterior 

common  spinal  ligament  to  the  basilar  process  of  the  occipital  bone. 
2  Lateral  Occipito-odontoid^  ( Check  Ligaments),  from  the  head  of  the  odontoid 

process  to  the  sides  of  the  occipital  condyles. 
Vertical  Occipito-odontoid  {Liganientum  Suspensorium),  from  the  anterior 

margin  of  the  foramen  magnum  to  the  odontoid  apex. 
Describe  the  Atlo-axoid  Articulation.     It  is  a  double  arthrodia  between  the 
articular  processes,  a  double  diarthrosis  rotatorius  between  the  atlas  and  the 
odontoid  process,  and  has  6  ligaments,  and  4  synovial  membranes. 

2  Anterior  and  i  Posterior  Atlo-axoid,  continuations  of  the  anterior  and  pos- 
terior common  spinal  ligaments. 
2  Capsular,  surrounding  the  articular  surfaces,  each  lined  by  a  synovial 

membrane. 
Transverse,  or  Cruciform  Ligament,  divides  the  spinal  foramen  of  the  atlas 
into  two  portions,  stretching  across  between  the  tubercles  on  the  inner 
sides  of  the  articular  processes.     It  holds  the  odontoid  process  in  place, 
having  a  synovial  membrane  interposed.     Another  synovial  membrane  is 
situated  between  the  process  and  the  anterior  arch.     The  transverse  liga- 
ment sends  two  vertical  slips,  one  upwards,  the  other  downwards,  from 
which  it  is  named  the  Cruciform  LJgament. 
Describe  the  Temporo-maxillary  Articulation.    A  double  arthrodia  between 
the  condyle  of  the  lower  jaw  and  the  anterior  part  of  the  glenoid  cavity  of  tho 
temporal  bone.      It  has  2  synovial  membranes  with  an  inter-articular   fibro- 
cartilage  between  them,  and  4  ligaments,  viz.^ 

External  Lateral,  from  the  tubercle  of  the  zygoma  to  the  outer  side  of  th« 
neck   pf  the  condyle   of  the 
lower  jaw. 
Lnternal  Lateral, d  ixovci  the  spine 
of  the  sphenoid  to  the  margin 
of    the   inferior   dental    fora- 
men. 
Stylo-maxillary,/  from  the  sty- 
loid process  of  the  temporal 
bone  to  the  angle  of  the  in- 
ferior maxillary. 


58  ANATOMY. 

Capsular^c  from  the  edge  of  the  glenoid  cavity  and  the  eminentia  articularis 
to  the  neck  of  the  inferior  maxillary  condyle. 
Nerves  are  derived  from  the  auriculo-temporal  and  masseteric   branches  of 
the  inferior  maxillary. 

Describe  the  Costo-vertebral  Articulations.     They  are  each  a  double  ar- 

throdia  between  the  head  of  the  rib  and  the  bodies  of  2  adjacent  vertebrae, 

except  in  the  ist,  loth,  nth,  and  I2th  ribs,  which  are  each  a  single  arthrodia, 

as  they  articulate  with  but  i  vertebra  each.     Their  ligaments  are  3,  viz. — 

Anterior    Costo-vertebral^    or    Stellate    Ligament,    consists    of    3    bundles, 

which  fasten  the  anterior  part  of 
^^°-  3^-  _  the   head  of  the    rib  to  the  inter- 

vertebral disk  and  the  2  adjacent 
bodies. 
Inter-articular  Costo-vertebral,  in  the 
interior  of  the  joint,  from  the  crest 
on  the  head  of  the  rib  to  the  inter- 
vertebral disk;  on  each  side  there 
is  a  separate  synovial  membrane. 
Capsular,  surrounding  the  articular 
surfaces. 

Describe  the  Costo-transverse  Articulations.  They  are  10  arthrodial  articu- 
lations between  the  tubercles  of  the  first  10  ribs  and  the  transverse  processes 
of  the  vertebrge  next  below.  Their  ligaments  are  3,  viz, — Anterior,  Middle, 
and  Posterior  Costo-transverse. 

Describe  the  Costo-stemal  Articulations.  One  a  synarthrodia!,  6  are  ar- 
throdial articulations,  between  the  costal  cartilages  and  the  margin  of  the 
sternum.  The  first  has  no  synovial  membrane,  the  second  only  has  an  inter- 
articular  fibro-cartilage.  Each  has  3  ligaments, — the  Anterior  and  Posterior 
Costo-stemal,  and  a  Capsular.  The  Costo-xiphoid  Ligament  connects  the  xiphoid 
appendix  to  the  cartilage  of  the  6th  or  7th  rib. 

How  are  the  Costal  Cartilages  connected  with  the  ribs  and  with  each 
other  ?  With  the  ribs  by  a  depression  on  the  end  of  each  rib,  strengthened  by 
the  blending  together  of  the  periosteum  and  the  perichondrium.  The  carti- 
lages of  the  lower  ribs,  sometimes  from  the  5th  to  the  loth  inclusive,  articu- 
late with  each  other  by  their  borders  and  for  each  a  capsular  and  an  intercostal 
ligament,  with  3  synovial  membranes  for  the  3  articulations  between  the 
6th  and  the  9th  cartilages. 

What  are  the  Ligaments  of  the  Sternum?  An  anterior  sternal  and  a 
posterior  sternal  ligament,  with  a  layer  of  cartilage  betv/een  the  manubrium 
and  the  gladiolus. 


THE  ARTICULATIONS. 


Fig.  32. 


Describe  the  Sacro-vertebral  Articulation.  It  is  similar  to  the  other  ver- 
tebral articulations,  but  has  2  additional  ligaments  on  each  side,  viz. — 

Lumbosacral^  from  the  transverse  processes  of  the  5th  lumbar  vertebra  to 

the  base  of  the  sacrum  laterally  and  anteriorly. 
Lumbo-iiiac,  from  the  apices  of  the  transverse  processes  of  the  5th  lumbar 

vertebra  to  the  crest  of  the  ilium. 
Describe  the  Sacro-coccygeal  Articulation.     It  is  an  amphiarthrodial  joint, 
and  has  3  ligaments,  viz. — 

Anterior  Sacro-coccygeal.  Posterior  Sacro-coccygeal. 

Interarticular  Fibro-cartilage,  in  the  joint. 

Describe  the  Sacro-iliac  Articulation.  It  is  an  amphiarthrodial  joint, 
formed  by  the  auricular  surfaces  of  the  sacrum  and  ilium.  Its  ligaments  on 
each  side  are  as  follows,  viz, — 

Anterior  Sacro-iliac.  Posterior  Sacro-iliac^ 

Oblique  Sacro-iliac. 
Describe   the   Sacro-ischiatic   Articulation.      Its    ligaments    convert  the 
sacro-sciatic  notches  into  foramina,  the  greater  notch  by  the  lesser  ligament, 
the   lesser   notch    by   the 
greater  ligament.     These 
foramina     are     described 
under  the  ilium   and   is- 
chium bones. 

Great  Sacr  o- sciatic 
Ligament,  ^'  ^*  from 
the  posterior  inferior 
spine  of  the  ilium 
and  the  posterior  sur- 
faces and  margins  of 
the  sacrum  and  coc- 
cyx, to  the  inner 
inargin  of  the  tuber- 
osity and  the  ascend- 
ing ramus  of  the 
ischium. 
Lesser  Sacro-sciatic  Ligament} 

into  the  spine  of  the  ischium. 
Describe  the  Pubic  Articulation.     It  is  an  amphiarthrodial  joint,  formed  by 
the  2  pubic  bones.    It  has  an  interarticular  fibro-cartilage  and  4  ligaments,  viz. — 
Anterior  Pubic.  Posterior  Pubic.  Su^ra-Jmbic. 

Sub-Jmbic,  forming  a  fibrous  arch  between  the  rami. 


16  from  the  margins  of  the  sacrum  and  coccyx. 


Describe  the  Sterno-clavicular  Articulation.  It  is  an  arthrodial  joint, 
formed  by  the  stei-nal  end  of  the  clavicle  with  the  sternum  and  the  cartilage 
of  the  1st  rib.  It  has  an  interarticular  fibro-cartilage,  2  synovial  membranes, 
and  4  ligaments,  viz. — 

Anterior  Sterno-clavicular.  Interclavicular. 

Posterior  Sterno-clavicular.  Costo-clavicular  or  Rhomboid. 

Describe  the  Scapulo-clavicular  Articulation.  It  is  an  arthrodial  joint, 
formed  by  the  outer  extremity  of  the  clavicle  and  the  acromion  process  of  the 
scapula.  It  frequently  has  an  interarticular  fibro-cartilage  and  2  synovial 
membranes;  usually  but  i  synovial  membrane  is  present,  and  3  ligaments, 


Coraco-clavicular^  j  Trapezoid,  externally, 
divided  into —     I  Conoid,  internally. 


Fig.  33. 


Superior  Acromio  clavicular} 
Inferior  Acromio-clavicular. 

What  are  the  proper  Ligaments  of  the  Scapula?     They  are  2,  the  coraco- 
acromial,  and  the  transverse,  as  follows. — 

Coraco-acromial^  completes  the  vault  par- 
tially formed  by  the  2  processes  over  the 
head  of  the  humerus. 
Transverse,^  from  the  base  of  the  coracoid 
process  to  the  margin  of  the  suprascapular 
notch,  converting  it  into  a  foramen,  for 
the  supra-scapular  nerve. 

Describe    the    Shoulder-joint.      It  is   an 

enarthrodial  joint,  formed  by  the  head  of  the 
humerus  and  the  glenoid  cavity  of  the  scapula. 
It  has  a  Synovial  Membrane  which  is  reflected 
upon  the  tendons  of  the  biceps,  subscapularis, 
and  infraspinatus  muscles,  and  communicates 
with  bursge  beneath  the  2  latter  tendons.  Its 
Arteries  are  derived  from  the  anterior  and 
posterior  circumflex  and  the  suprascapular; 
its  Nerves  from  the  circumflex  and  the  supra- 
scapular.    It  has  3  ligaments,  viz, — 

Capsular^  from  the  margin  of  the  glenoid  cavity  to  the  anatomical  neck  of 
the  humerus ;  has  3  openings  for  the  reflexions  of  the  synovial  membrane 
over  the  tendons. 
Coraco-humeral,^  intimately  united  with  the  capsular,  extends  from  the  cora- 
coid process  to  the  greater  tuberosity. 
Glenoid^  a  fibro-cartilaginous  ring,  continuous  above  with  the  tendon  of  the 


THE   ARTICULATIONS. 


6] 


long  head  of  the  biceps,'  and  attached  around  the  mar-  Fig 

gin  of  the  glenoid  cavity  in  order  to  deepen  the  articu- 
lar surface. 
Describe  the  Elbow-joint.  It  is  a  ginglymus  articulation, 
formed  by  the  lower  end  of  the  humerus  with  the  greater 
sigmoid  cavity  of  the  ulna  and  the  head  of  the  radius.  Its 
Synovial  Membrane  is  reflected  over  the  ligaments,  and  dips 
down  between  the  surfaces  of  the  superior  radio-ulnar  articu- 
lation. Its  Arteries  are  derived  from  the  anastomotica  magna, 
radial, ulnar,  and  interosseous  recurrent,  superior  and  inferior 
profunda  arteries.  Its  Nerves  are  branches  of  the  ulnar  and 
the  musculo-cutaneous.     It  has  4  ligaments, — 

Anterior^  from  the  inner  condyle  and  anterior  surface  of 
the  humerus  to  the  orbicular  ligament  of  the  radius  and 
the  coronoid  process  of  the  ulna. 
Posterior,  from  the  posterior  surface  of  the  humerus  to  the 

olecranon  process  of  the  ulna. 
External  Lateral,^  from  the  external  condyle  of  the  hu- 

merus  to  the  orbicular  ligament  of  the  radius. 
Internal  Lateral,  from  the  internal  condyle  of  the  humerus 

to  the  coronoid  and  olecranon  processes  of  the  ulna. 
Describe  the  Radio-ulnar  Articulations.    They  are  3  in  number,  as  follows, 
viz. — 

Superior  radio-ulnar  articulation  is  a  lateral  ginglymoid  joint,  formed 
by  the  head  of  the  radius  and  the  lesser  sigmoid  cavity  of  the  ulna.  Its 
synovial  membrane  is  a  continuation  of  that  in  the  elbow-joint.  It  has  I 
ligament,  the — 

Orbicular  Ligament^  forms  four- fifths  of  a  circle  and  surrounds  the  neck  ot 

the  radius.     It  is  attached  to  the  margins  of  the  lesser  sigmoid  cavity  of 

the  ulna,  and  to  the  external  lateral  ligament  of  the  elbow-joint. 

Middle  radio-ulnar  articulation  is  formed  by  the  shafts  of  the  radius 

and  ulna,  which  do  not  touch  each  other,  but  are  connected  by  2  ligaments,  as* 

foUows,  viz. — 

Oblique  Ligament,  from  the  tubercle  at  the  base  of  the  coronoid  process  of 

the  ulna  to  the  shaft  of  the  radius. 
Interosseous  Me??ibrane?  obliquely  downwards  from  the  interosseous  ridge  on 
the  radius  to  that  on  the  ulna.     Through  the  interval  between  its  upper 
border  and  the  oblique  ligament,  the  posterior  interosseous  vessels  pass. 
Inferior  radio-ulnar  articulation  is  a  lateral  ginglymoid  joint,  formed 
by  the  head  of  the  ulna  and  the  sigmoid  cavity  of  the  radius.     Its  Synovia. 
Membrane  (membrana  sacciformis)  is  very  loose,  and  sometimes  communicates 
6 


82  ANATOMY. 

with  that  of  the  wrist -joint  through  an  opening  in  the  triangular  fibrocartilagi 
which  separates  the  head  of  the  ulna  from  the  wrist-joint,  and  acts  as  one  of 
the  ligaments  of  this  articulation,  which  are  3,  viz. — 

Anterior  Radio-ulnar.  Posterior  Radio-ulnar. 

Triangular  Interarticular  Fibre- cartilage. 
Describe  the  Wrist-joint.  It  is  chiefly  an  enarthrodial  articulation,  though 
Incapable  of  rotation,  and  is  formed  by  the  lower  end  of  the  radius  and  the  tri- 
angular fibro-cartilage,  with  the  scaphoid, semilunar,  and  cuneiform  bones  of  the 
carpus.  Its  Arteries  are  the  anterior  and  posterior  carpal  from  both  the  radial 
and  ulnar,  the  anterior  and  posterior  interosseous  and  ascending  branches  from 
the  deep  palmar  arch.  Its  Nerves  are  derived  from  the  ulnar;  it  is  lined  by  a 
synovial  membrane^  and  has  4  ligaments,  viz. — 

External  Lateral  (radio-carpal).  Anterior. 

Internal  Lateral  (ulno-carpal).  Posterior, 

Describe  the  Carpal  Articulations.  They  are  in  3  sets,  (i)  between  the 
bones  of  the  first  row,  (2)  between  the  bones  of  the  second  row,  (3)  between 
the  2  rows  of  bones. 

(1)  The  scaphoid,  semilunar,  and  cuneiform  bones  are  connected  together 
by  2  Dorsal,  2  Palmar ^  and  2  Interosseous  Ligaments.  The  pisiform  bone 
has  a  separate  capsular  ligament  and  synovial  membrane  and  2  fasciculi 
connecting  it  with  the  unciform  and  the  5th  metacarpal. 

(2)  The  4  bones  of  the  second  row  are  connected  together  by  j  Dorsal,  j 
Palmar,  and  j  Interosseous  Ligaments. 

(3)  The  2  rows  of  bones  are  united  by  a  Dorsal,  a  Palmar,  and  2  Lateral 
Ligaments,  the  last  named  being  continuous  with  the  lateral  ligaments  of 
the  wrist-joint. 

Describe  the  Carpo-metacarpal  Articulations.  That  of  the  thumb  with  the 
«rapezium  is  an  enarthrodial  joint,  having  a  Capsular  Ligament  and  a  separate 
synovial  membrane.  The  4  inner  metacarpal  bones  form  4  arthrodial  joints 
with  the  adjacent  carpal  bones  by  6  Dorsal,  8  Palmar,  and  2  Interosseous  Liga- 
ments, irregularly  disposed. 

Describe  the  Synovial  Membranes  of  the  Wrist.  They  number  5,  and  are 
•ituated  as  follows,  viz. — 

The  First,  or  Membrana  Sacciformis,  between  the  head  of  the  ulna,  the  sig- 
moid cavity  of  the  radius,  and  the  triangular  interarticular  fibro-cartilage. 
The  Second,  between  the  lower  end  of  the  radius,  the  triangular  fibro-carti- 
lage, and  the  scaphoid,  semilunar,  and  cuneiform  bones  of  the  carpus. 
The  Third,  between  all  the  carpal  bones  except  the  pisiform,  and  between 
the  bases  of  the  inner  4  metacarpal  bones ;  but  it  extends  only  halfway 
into  the  2  intervals  between  the  3  proximal  bones  of  the  carpus. 


THE  ARTICULATIONS.  08 

Che  Fourth,  between  the  trapezium  and  the  metacarpal  bone  of  the  thumb. 
The  Fifth,  between  the  cuneiform  and  pisiform  bones. 

Describe  the  Metacarpo-metacarpal  Articulations.  The  4  inner  meta- 
jarpal  bones  are  connected  together  at  their  bases  by  Dorsal,  Palmar,  and 
Interosseous  Ligaments;  and  at  their  digital  extremities  by  the  Transverse 
Ligament. 

Describe  the  remaining  Articulations  of  the  Hand.  The  metacarpo- 
phalangeal and  the  phalangeal  articulations  are  all  ginglymoid  joints,  and  each 
has  an  Anterior  and  2  Lateral  Ligaments,  the  former  being  lined  each  with  a 
synovial  membrane.  There  are  no  posterior  ligaments  to  these  articulations, 
the  extensor  tendons  of  the  hand  supplying  their  places. 

Describe  the  Hip-joint.  It  is  a  true  enarthrodial  articulation,  formed  by 
the  head  of  the  femur  with  the  acetabulum  of  the  os  innominatum.  Its  Syno- 
vial Membrane  is  extensive,  investing  most  of  the  head  and  neck  of  the  femur, 
the  capsular,  cotyloid  and  teres  ligaments,  and  the  cavity  of  the  acetabulum. 
Its  Arteries  are  derived  from  the  obturator,  sciatic,  internal  circumflex,  and 
gluteal.  Its  Nerves  are  branches  from  the  sacral  plexus,  great  sciatic,  obtu- 
rator, and  accessory  obturator.     It  has  5  ligaments,  as  follows,  viz. — 

Capsular,  from  the  margin  of  the  acetabulum  and  the  transverse  ligament, 
into  the  base  of  the  neck  of  the  femur  above,  the  anterior  inter-trochan- 
teric  line  in  front,  and  to  the  middle  of  the  neck  of  the  bone,  behind. 
Iliofemoral  or  Y-ligament,  from  the  anterior  inferior  spine  of  the  ilium,  into 
the  anterior  inter-trochanteric  line  by  two  fasciculi.     It  is  a  dissected  por- 
tion of  the  capsular  ligament  which  is  very  strong  anteriorly. 
Ligamentum  Teres,  from  a  depression  on  the  head  of  the  femur  into  the 
margins  of  the  cotyloid  notch  of  the  acetabulum  and  into  the  transverse 
ligament,  by  two  fasciculi. 
Cotyloid,  a  fibro-cartilaginous  band  surrounding  the  margin  of  the  acetab- 
ulum in  order  to  deepen  its  cavity. 
Transverse,  that  part  of  the  cotyloid  ligament  which  crosses  over  the  coty- 
loid notch  converting  it  into  a  foramen. 
Describe  the  Knee-joint.     It  is  a  ginglymus  articulation,  formed  by  the 
condyles  of  the  femur  with  the  head  of  the  tibia,  and  the  patella  in  front.     Its 
Synovial  Membrane  is  the  largest  in  the  body,  being   reflected  for  2   or  3 
inches  over  the  anterior  surface  of  the  femur,  where  it  is  supported  by  the  sub- 
crureus  muscle,  also  over  its  condyles,  the  patella,  semilunar  cartilages,  crucial 
ligaments,  and  head  of  the  tibia ;  and  is  prolonged  through  an  opening  in  the 
capsular  ligament  beneath  the  tendon  of  the  popliteus.    Its  Arteries  are  derived 
from  the  anastomotica  magna,  the  5  articular  branches  of  the  popliteal,  and 
the  recurrent  branch  of  the  anterior  tibial.     Its  Nerves  are  branches  of  the 


M 


ANATOMY. 


obturator,  anterior  crural,  external  and  internal  popliteal.     It  has  14  ligaments, 
of  which  6  are  external  and  8  internal,  as  follows : —  * 
Anterior^  or  Ligamenhun  Patella;,  is  a  continuation  of  the  tendon  of  the 


Fig.  35. 


rectus  femoris  muscle,  extending  from  the  apex  of  the 
patella  to  the  lower  part  of  the  tubercle  of  the  tibia. 
Posterior,  or  Ligamentum  IVinslowii}  from  the  inner 
tuberosity  of  the  tibia  to  the  external  condyle  of  the 
femur,  being  partly  derived  from  the  tendon  of  the 
semimembranosus  muscle.^ 
Internal  Lateral;^  from   the   internal   condyle  of  the 
femur  to  the  internal  surface  of  the  tibia  and  semi- 
lunar cartilage. 
2  External  Lateral^  from  the  external  condyle  of  the 
femur  to  the  head  of  the  fibula.     These  ligaments  are 
a  Long  anteriorly  and  a  Short  posteriorly,  separated 
by  the  tendon  of  the  biceps. 
Capsular,  is  only  present  where  intervals  are  left  by  the 
preceding  ligaments.     It  is  thin  but  very  strong. 
The  Internal  ligaments  are  as  follows : — 
Anterior  Crucial^  from  the  depression  in  front  of  the  spine  of  the  tibia  to 

the  inner  side  of  the  outer  condyle  of  the  femur. 
Posterior  Crucial?  from  the  same  depression,  to  the  outer  side  of  the  innef 
condyle.  [To  remember  the  positions  and  insertions  of  these  crucial  liga- 
ments, let  the  student  cross  his  index  fingers  over  each  knee  in  succession; 
when  over  the  right  knee  placing  the  right  finger  in  front,  when  over  the 
left  knee  the  left  finger  in  front.  The  positions  of  the  fingers  will  then  in 
each  case  correspond  with  those  of  the  respective  crucial  ligaments.] 


Fig.  36. 


2  Semilunar  Fibro-cartilages?  external  and  internal,  are 
situated  between  the  articular  surfaces,  and  attached  to 
the  depressions  in  front  and  behind  the  spine  of  the  tibia. 

Transverse,^  is  a  connecting  slip  between  the  semilunar 
fibro- cartilages  anteriorly. 

Coronary?  are  short  bands  connecting  the  outer  margins 
of  the  fibro-cartilages  to  the  tibia  and  the  adjacent  lig- 
aments. 

Liganientutn  Mucosum,  is  a  triangular  fold  of  the  syn 
ovial  membrane  which  at  the  lower  border  of  the  patella 
is  given  off  to  the  intercondyloid  notch  of  the  femur. 

Ligamenta  Alaria,  are  fringes  on  the  sides  of  the  liga- 
mentum mucosum,  and  are  attached  to  the  sides  of 
the  patella. 


THE  ARTICULATIONS.  66 

Bursce  in  the  vicinity  of  this  joint  are  5,  viz. — i  under  the  ligamentum  patellae,' 
I  between  the  patella  and  the  skin ;  i  between  the  internal  lateral  ligament 
and  the  tendons  crossing  it ;  sometimes  i  replacing  the  synovial  pouch  on  the 
anterior  surface  of  the  femur ;  and  occasionally  i  in  the  popliteal  space  re- 
placing the  synovial  pouch  usually  situated  therein. 

Describe  the  Tibio-fibular  Articulations.  They  are  3  in  number,  as 
follows,  viz. — 

Superior  tibio-fibular  articulation,  is  an  arthrodial  joint,  formed  by 
the  contiguous  surfaces  of  the  bones.  It  has  a  Synovial  Membrane  which  is 
sometimes  continuous  with  that  of  the  knee-joint,  and  2  ligaments,  the — 

Anterior  and  Posterior  Supet'ior  Tibio-fibular}^  which  connect  the  head  of 
the  fibula  with  the  outer  tuberosity  of  the  tibia. 

Middle  tibio-fibular  articulation.  The  shafts  of  these  bones  do  not 
touch  each  other,  but  are  connected  by  the  Interosseous  Membrane  extending 
between  their  contiguous  borders,  and  perforated,  above  for  the  anterior  tibial 
artery,  below  for  the  anterior  peroneal  vessels. 

Inferior  tibio-fibular  articulation,  is  an  amphi-arthrodial  joint, 
formed  by  the  contiguous  rough  surfaces  on  the  bones.  Its  Synovial  Mem- 
brane is  derived  from  that  of  the  ankle-joint,  and  it  has  4  ligaments,  viz. — 

Inferior  Interosseous,  continuous  with  the  interosseous  membrane. 

Anterior  and  Posterior  Inferior  Tibiofibular,  from  the  margins  of  the  ex- 
ternal malleolus  to  the  front  and  back  of  the  tibia. 

Transverse,  posteriorly  between  the  2  malleoli. 

Describe  the  Ankle-joint.     It  is  a  ginglymoid  articulation,  formed  by  the 

lower  ends  of  the  tibia  and  fibula  and  their  malleoli,  with  the  astragalus.  Its 
Synovial  Membrane  is  prolonged  upwards  between  the  tibia  and  fibula  for  a 
short  distance.  Its  arteries  are  derived  from  the  malleolar  branches  of  the 
anterior  tibial  and  peroneal  arteries ;  and  its  Nerves  from  the  anterior  tibial 
nerve.     It  has  3  ligaments,  viz. — 

Anterior,  connecting  the  margins  of  the  tibia  and  astragalus. 

Internal  Lateral,  or  Deltoid  Ligament,  from  the  internal  malleolus  to  the 

3  adjacent  tarsal  bones. 
External  Lateral,  by  anterior  posterior  and  middle  fasciculi,  from  the  ex- 
ternal malleolus  to  the  astragalus  and  os  calcis. 
Describe  the  Tarsal  Articulations.     They  are  in  3  sets,  (i)  between  the 
bones  of  the  first  row,  (2)  between  the  bones  of  the  second  row,  (3)  between 
the  2  rows  of  bones. 
(l.)  The  astragalus  and  os  calcis  are  united  by  3  ligaments. 

External  Calcaneoastragaloid.  Interosseous. 

Posterior  Calcaneo-astragaloid. 
6*  E 


96  ANATOMY. 

(2.)  The  scaphoid,  cuboid,  and  three  cuneiform  bones  are  united  by  an  ir 
regular  number  of  Dorsal  and  Plantar  and  4  Interosseus  ligaments,  whicli 
latter  are  arranged  transversely. 
(3.)  The  2  rows  of  lx)nes  are  united  by  7  ligaments  viz. — 

Superior  Astragaloscaphoid.  Inferior  Calcaneo-scaphoid. 

Superior  Calcaneo-cuboid.  Short  Calcaneo-cuboid. 

Superior  Calcaneo-scaphoid.  Long  Calcaneo-cuboid. 

Interosseous.^  or  Internal  Calcaneo-cuboid. 
Describe  the  Tarso-metatarsal  Articulations.  They  are  5  arthrodial 
joints  formed  by  the  bases  of  the  metatarsal  bones  with  the  adjacent  bones 
of  the  tarsus,  the  2d  metatarsal  bone  articulating  with  all  3  cuneiform  in 
the  recess  formed  by  the  shortness  of  the  second  cuneiform.  They  are  united 
by  Dorsal^  Plantar,  and  3  Interosseous  Ligaments.  The  2d  metatarsal  bone 
has  3  dorsal  ligaments,  i  from  each  cuneiform  bone.  The  interosseous 
ligaments  pass  from  the  2d  and  3d  metatarsal  bones  to  the  internal  and  Ex- 
ternal cuneiform. 

Describe  the  S3niovial  Membranes  of  the  Tarsus  and  Metatarsus. 
They  are  6  in  number,  and  are  situated  as  follows,  viz. — 

The  First,  between  the  os  calcis  and  the  astragalus,  behind  the  interosseous 

ligament. 
The  Second,  between  the  same  bones  in  front  of  the  interosseous  ligament, 

also  between  the  astragalus  and  the  scaphoid. 
The  Third,  between  the  os  calcis  and  the  cuboid. 

The  Fourth,  between  the  scaphoid  and  the  3  cuneiform  bones,  running 
backwards  between  the  scaphoid  and  the  cuboid,  forwards  between  the 
cuneiform  bones,  between  the  external  cuneiform  and  the  cuboid,  between 
the  middle  and  external  cuneiform  and  the  bases  of  the  2d  and  3d 
metatarsal,  passing  also  between  the  bases  of  these  bones  and  the  4th 
metatarsal. 
The  Fifth,  between  the  cuboid  and  the  4th  and  5th  metatarsal  bones,  also 

running  forwards  between  their  bases. 
The  Sixth,  between  the  internal  cuneifonn  and  the  base  of  the  1st  meta- 
tarsal bone. 
Describe  the  Metatarso-metatarsal  Articulations.     The  metatarsal  bones 
are  connected  together,  except  the  first,  at  their  l)ases  by  Dorsal,  Plantar,  and 
Interosseous  Ligaments ;  and  all  5  are  connected  at  their  digital  extremities 
by  the  Transverse  Metatarsal  Ligament. 

Describe  the  remaining  Articulations  of  the  Foot.  The  metatarso- 
phalangeal and  the  phalangeal  articulations  are  similar  to  those  in  the  hand, 
each  having  an  Interior  or  Plantar,  and  2  Lateral  Ligaments.  The  extensoi 
lendons  of  the  foot  supply  the  places  of  posterior  ligaments. 


THE  MUSCLES   AND   FASCIAE.  67 

THE   MUSCLES   AND   FASCIA. 

What  arc  the  Muscles?  They  are  the  active  organs  of  locomotion,  formed 
of  bundles  of  reddish  fibres  endowed  with  the  property  of  shortening  themselves 
upon  irritation,  which  is  called  muscular  contractility,  and  chemically  consisting 
of  syntonin,  or  muscular  fibrin. 

How  are  the  Muscles  divided  ?  Into  2  great  classes,  ( i )  Voluntary,  Striped, 
or  Muscles  of  animal  life,  comprise  those  which  are  under  the  control  of  the 
will.  (2)  Invohmtary,  Unstriped,  or  Muscles  of  organic  life,  are  those  which 
are  not  under  the  control  of  the  will. 

Voluntary  Muscular  Fibre  consists  of  fasciculi  about  -^\-^  inch  in  diameter, 
each  surrounded  by  a  tubular  membranous  sheath,  the  perimysium;  and  marked 
by  fine  strise  passing  around  them  in  curved  parallel  lines  about  yt^cTo  ^"^^ 
apart.  These  fasciculi  are  formed  oi  fbrillcB,  each  about  yg^^-jy  inch  thick, 
also  striated,  presenting  the  appearance  of  a  row  of  minute  particles,  the 
"sarcous  elements"  of  Bowman,  and  surrounded  by  cellular  tissue,  the  sarco- 
lemma. 

Involuntary  Muscular  Fibre  consists  of  flattened  fusiform  or  spindle-shaped 
fibres,  averaging  about  :joViT  ^^'^^  ^'^  breadth,  consisting  of  elongated  cells,  and 
bound  together  in  bundles  by  areolar  tissue.  These  fibres  are  found  in  the 
alimentary  canal,  in  the  posterior  wall  of  the  trachea,  in  the  bronchi,  the  ducts 
of  certain  glands,  in  the  ureters,  bladder,  urethra,  genitalia  of  both  sexes,  walls 
of  all  arteries  and  most  veins  and  lymphatics,  in  the  iris  and  ciliary  muscle, 
and  in  the  skin. 

What  are  Tendons  and  Aponeuroses  ?  Tendons  are  white,  glistening  cords 
or  bands  formed  of  white  fibrous  tissue  almost  entirely,  have  few  vessels  and 
no  nerves,  and  serve  to  connect  the  muscles  with  the  structures  on  which  they 
act.  Aponeuroses  are  fibrous  membranes,  of  similar  structure  and  appearance, 
and  serve  the  same  purpose. 

What  are  Fasciae  ?  They  are  laminae  of  variable  thickness  which  invest 
[fascia,  a  bandage)  the  softer  structures.  The  superficial  fascia  is  composed 
of  fibro-areolar  tissue,  and  is  found  beneath  the  skin  almost  over  the  whole 
body.  The  deep  fascia  is  of  aponeurotic  structure,  dense,  inelastic,  and  fibrous, 
ensheathing  the  muscles  and  affording  some  of  them  attachment,  also  the  vessels 
and  nerves,  and  binding  down  the  whole  into  a  shapely  mass. 

To  what  Structures  are  Muscles  attached  ?  To  the  periosteum  and  peri- 
chondrium of  bone  and  cartilage,  to  the  subcutaneous  areolar  tissue,  and  to 
ligaments.  In  the  latter  case  only  are  their  tendons  in  direct  contact  with  the 
tissue  on  which  they  are  to  act. 

How  many  Muscles  are  Double-bellied  ?  Five, — the  occipito -frontal is, 
biventer  cervicis,  digastric,  omo-hyoid,  and  the  diaphragm. 


68  ANATOMY. 

Describe  each  Muscle  of  the  Body,  giving  its  Origin,  Insertion,  Action, 

and  Nervous  supply. 

MUSCLES   OF   THE    HEAD. 
Occipito-frontalis,«  from  the  external  two-thirds  of  the  superior  curved  line 

of  the  occipital  bone  and  the  mastoid  process  of  the  temporal;  also  from  the 

pyramidalis  nasi,  corrugator  supercilii,  and  orbicularis  palpebrarum  fibres, — 

into  an  aponeurosis  or  ''galea  capitis,"  which  covers  the  vertex  of  the  skull. 

Action,  chiefly  as  a  muscle  of  facial  expression.    Nerves,  facial,  supraorbital, 

small  occipital. 
Attollens  Aurem,  fro?n  the  occipito-frontalis  aponeurosis, — into  the  pinna  of 

the  ear  superiorly.    Action,  to  raise  the  pinna.    Nerve,  small  occipital  branch 

of  the  cervical  plexus. 
Attrahens  Aurem,  from  the  lateral  cranial  aponeurosis, — into  the  helix  of  the 

ear  anteriorly.     Action,  to  draw  the  pinna  foi-wards.     Nerves,  facial,  and 

auriculotemporal  branch  of  the  inferior  maxillary. 
Retrahens  Aurem,  from  the  mastoid  process  of  the  temporal  bone, — into  the 

concha.     Action,  to  retract  the  pinna.     Nerve,  facial. 
Orbicularis  Palpebrarum, /r(9w  the  internal  angular  process  of  the  frontal  bone, 

the  nasal  process  of  the  superior  maxillary,  and  the  borders  of  the  tendo 

oculi, — into  the  skin  of  the  eyelids,  forehead,  temple,  and  cheek,  blending 

with  the  occipito-frontalis  and  the  corrugator  supercilii.    Action,  to  close  the 

eyelids.     Nerve,  facial. 
Corrugator  Supercilii,  from  the  inner  end  of  the  superciliary  ridge  of  the 

frontal  bone, — into  the  orbicularis  palpebrarum.     Action,  to  draw  eyebrow 

downwards  and  inwards.     Nerve,  facial. 
Tensor  Tarsi  (Horner's  muscle), /rcz«  the  crest  of  the  lachrymal  bone, — into 

the  tarsal  cartilages  by  two  slips.     Action,  to  compress  the  puncta  lachry- 

malia  against  the  globe  of  the  eye,  and  to  compress  the  lachrymal  sac. 

N'erve,  facial. 
Levator  Palpebrae  Superioris, /rt?///  the  lesser  wing  of  the  sphenoid, — into  the 

upper  tarsal  cartilage.     Action,  to  lift  the  upper  lid.     Nerve,  3d  cranial,  or 

motor  oculi. 
Rectus  Superior,  from  the  upper  margin  of  the  optic  foramen  and  the  sheath 

of  the  optic  nerve,— into  the  sclerotic  coat.     Action,  to  rotate  the  eyeball 

upwards.     Nerve,  3d  cranial. 
Rectus  Inferior,  frofu  the  ligament  of  Z\nn,— into  the  sclerotic  coat.     Action, 

rotates  the  eyeball  downwards.     Nerve,  3d  cranial. 
Rectus  Intemus,  from  the  ligament  of  Zinn, — into  the  sclerotic  coat.     Action^ 

rotates  the  eyeball  inwards.     Nerve,  3d  cranial. 


MUSCLES   OF  THE   HEAD. 


69 


Rectus  Externus,  by  2  heads,  the  upper  from  the  outer  margin  of  the  optic- 
foramen,  the  lower  from  the  ligament  of  Zinn  and  a  bony  process  at  lower 
margin  of  the  sphenoidal  fissure, — into  the  sclerotic  coat.  Action^  to  rotate 
the  eyeball  outwards.     Nerve,  6th  cranial,  or  abducens. 

Between  the  2  heads  of  the  external  rectus  pass  the  3d,  nasal  branch  of  the 
5th,  and  the  6th  cranial  nerves,  and  the  ophthalmic  vein. 

Obliquus  Superior,  from  about  a  line  above  the  inner  margin  of  the  optic 
foramen,  its  tendon  passing  through  a  "  pulley  "  near  the  internal  angular 
process  of  the  frontal  bone  and  thence  beneath  the  rectus  superior, — into 
the  sclerotic  coat  at  right  angles  to  the  insertion  of  the  rectus  superior. 
Action,  to  rotate  the  eyeball  on  its  antero-posterior  axis.  Nerve,  4th  cranial, 
or  pathetic  us. 

Obliquus  Inferior,  y^-^^/z  the  orbital  plate  of  the  superior  maxillary, — into  the 
sclerotic  coat  below  the  insertion  of  the  external  rectus  and  at  right  angles 
thereto.  Action,  to  rotate  the  eye  on  its  antero-posterior  axis.  Nerve,  3d 
cranial. 

Pyramidalis  Nasi,^  from  the  occipito-frontalis, — into  the  compressor  naris. 
Action,  to  depress  the  eyebrow.     Nerve,  facial. 

Levator  Labii  Superioris  Alaeque  Nasi,^  from  the  nasal  process  of  the 
superior  maxillary  bone, — into  the  cartilage  of  the  ala  of  the  nose  and  into 
the  upper  lip.  Action,  to  elevate  the  upper  lip,  and  dilate  the  nostril. 
Nerve,  facial. 

Dilator  Naris  Anterior,  from  the  cartilage  of  the  ala, — into  the  border  of  ita 
integument.     Action,  to  dilate  the  nostril.     Nerve,  facial. 


Dilator  Naris  Posterior, /r^w  the  nasal 
notch  of  the  superior  maxillary  and 
the  sesamoid  cartilages, — into  the  in- 
tegument at  the  margin  of  the  nostril. 
Action,  to  dilate  the  nostril.  Nerve, 
facial. 

Compressor  Naris,«^  from  the  superior 
maxillary  above  the  incisive  fossa, — 
into  the  fibro- cartilage  of  the  nose, 
being  continuous  with  its  fellow  and 
the  pyramidalis  nasi  aponeurosis.  Ac- 
tion, to  dilate  the  nostril.    Nerve,  facial. 

Compressor  Narium  Minor,  from  the 
alar  cartilage, — into  the  skin  at  the 
end  of  the  nose.  Action,  to  dilate  the 
nostril.     Nerve,  facial. 


Fig.  37. 


70  ANATOMY, 

Depressor  Alae  "Nasi,  from  the  incisive  fossa  of  the  superior  ^xillary, — tnfa 
the  septum  and  ala  of  the  nose.  Action,  to  contract  the  nostril.  Nerve, 
facial. 

Levator  Labii  Superioris,///-fw  the  lower  margin  of  the  orbit, — into  the 
upper  lip.     Action,  to  elevate  the  lip.     Nerve,  facial. 

Levator  Anguli  Oris,o  from  the  canine  fossa  of  the  superior  maxillary, — into 
the  angle  of  the  mouth.     Action,  as  named.     Nerve,  facial. 

Zygomaticus  Major/^  from  the  malar  bone, — into  the  angle  of  the  mouth. 
Action,  to  raise  the  lip  outwards.     Nerve,  facial. 

Zygomaticus  Minor,^  from  the  malar  bone  anteriorly, — into  the  angle  of  the 
mouth,  blending  with  the  levator  labii  superioris.  Action,  to  raise  the  lip 
outwards.     Nerve,  facial. 

Levator  Labii  Inferiorisw  (Levator  Menti),/rt?w  the  incisive  fossa  of  the  in- 
ferior maxillary  bone, — into  the  integument  of  the  chin.  Action,  as  named. 
Nerve,  facial. 

Depressor  Labii  Inferioris'^  (Quadratus  Menti),/r(?/«  the  external  oblique  line 
of  the  inferior  maxillary  bone, — into  the  lower  lip.  Action,  as  named. 
Nerve,  facial. 

Depressor  Anguli  Oris«  (Triangularis  Menti),/rc'/«  the  external  oblique  line 
of  the  inferior  maxillary, — into  the  angle  of  the  mouth.  Action,  as  named. 
Nerve,  facial. 

Orbicularis  Oris,'^  by  accessory  fibres  (accessorii  orbicularis  superioris  and  in- 
ferioris,  and  naso-labialis)  from  the  nasal  septum  and  the  superior  and  in- 
ferior maxillary  borders, — into  the  buccinator  and  other  adjacent  muscles, 
forming  the  sphincter  of  the  mouth.  Action,  to  close  the  mouth.  Nerve, 
facial. 

Buccinator,/  from  the  posterior  alveolar  processes  of  both  the  maxillary 
bones  and  the  pterygo-maxillary  ligament, — into  the  orbicularis  oris.  Ac- 
tion, to  compress  the  cheeks.  Nerves,  facial,  and  the  buccal  branch  of  the 
inferior  maxillary. 

Risorius,  from  the  fascia  over  the  masseter  muscle, — into  the  angle  of  the 
mouth.     Action,  the  laughing  muscle.     Nerve,  facial. 

Masseter,^  from  the  anterior  two-thirds  and  the  inner  surface  of  the  zygoma 
and  the  malar  process  of  the  superior  maxillary, — into  the  angle,  ramus,  and 
coronoid  process  of  the  lower  jaw.  Action,  to  raise  the  back  part  of  the 
lower  jaw  ;  a  muscle  of  mastication.     Nerve,  inferior  maxillary. 

Temporal,  from  the  temporal  fossa  and  temporal  fascia, — into  the  coronoid 
process  of  the  inferior  maxillaiy.  Action,  to  bring  the  incisor  teeth  together; 
the  biting  muscle.     Nerve,  inferior  maxillary. 


MUSCLES   OF  THE  EAR   AND   NECK.  71 

mtemal  Pterygoid, /r^w  the  pterygoid  fossa  of  the  sphenoid  bone,  and  the 
tuberosity  of  the  palate, — into  the  angle  and  inner  surface  of  the  ramus  of 
the  jaw,  as  high  as  the  dental  foramen.  Action^  raises  and  draws  for- 
ward the  lower  jaw;  a  triturating  muscle  of  mastication.  Nerve,  inferior 
maxillary. 

External  Pterygoid,  by  2  heads,  the  upper,  from  the  pterygoid  ridge  on  the 
greater  wing  of  the  sphenoid,  the  lower  from  the  external  pterygoid  plate, 
and  the  tuberosities  of  the  palate  and  superior  maxillary  bones, — into  a 
depression  in  front  of  the  condyle  of  the  inferior  maxillary,  and  the  inter- 
articular  fibro-cartilage.  Action,  to  draw  the  jaw  forwards;  a  triturating 
muscle  of  mastication.     Nerve,  inferior  maxillary. 

Between  the  two  heads  of  the  external  pterygoid  muscle  passes  the  internal 
maxillary  artery. 

MUSCLES  OF  THE   EAR. 

Tensor  Tympani,  from  the  under  surface  of  the  petrous  portion  of  the  tem- 
poral bone,  the  cartilaginous  Eustachian  tube,  and  its  own  osseous  canal, — 
into  the  handle  of  the  malleus.  Action,  to  draw  the  membrana  tympani 
tense.     Nerve,  branch  from  otic  ganglion. 

Laxator  Tympani  Major,  from  the  spinous  process  of  the  sphenoid  and  the 
cartilaginous  Eustachian  tube, — through  the  Glasserian  fissure  to  the  neck 
of  the  malleus  just  above  the  processus  gracilis.  Action,  to  relax  the  mem- 
brana tympani.     Nerve,  tympanic  branch  of  the  facial. 

Laxator  Tympani  Minor, /rcw  the  back  of  the  external  meatus, — passes  be- 
tween the  layers  of  the  membrana  tympani  into  the  handle  of  the  malleus 
and  processus  brevis.  Action,  to  relax  the  membrana  tympani.  Considered 
a  ligament  by  many  anatomists  (the  lig.  mallei  posticum). 

Stapedius, /r(?w  the  interior  of  the  pyramid, — through  the  orifice  at  its  apex 
into  the  neck  of  the  stapes.  Action,  to  depress  the  base  of  the  stapes. 
Nerve,  filament  from  the  facial. 

MUSCLES  OF  THE  NECK. 

Platysma  yiyox&t.'^,  from  the  clavicle,  the  acromion,  and  the  fascia  covering 
the  pectoral,  deltoid,  and  trapezius  muscles, — into  the  lower  jaw,  the  angle 
of  the  mouth,  and  the  cellular  tissue  of  the  face.  Action,  to  wrinkle  the 
skin,  and  depress  the  mouth.     Nerves,  facial  and  superficial  cervical. 

Sterno-cleido-mastoidj^i  by  two  heads  from  the  sternum  12  and  the  clav 
icle^^  at  its  inner  third, — into  the  mastoid  process  of  the  temporal  bone, 
and  the  superior  curved  line  of  the  occipital.  Action,  to  depress  and 
rotate  the  head.  Nerves,  spinal  accessory,  and  branches  of  the  cervical 
plexus. 


a 


ANATOMY. 


Between  the  sternal  and 
clavicular  origins  is  a 
fossa,   the  fonticulus 
gutturis,  which  rises 
and   falls  during  la- 
bored breathing. 
Sterno-hyoid,  i*     from 
the  posterior  surface 
of  the   sternum  and 
the  sternal  end  of  the 
clavicle,  —  into     the 
body    of    the    hyoid 
bone.     Action,  to  de- 
press the  hyoid  ])one. 
Nerve,  a  branch  from 
the      communicating 
loop  between  the  de- 
scend ens    and    com- 
municans  noni. 
Stemo-thyroid,*5y^^w  the  posterior  surface  of  the  sternum  and  the  cartilage 
of  the  1st  rib, — into  the  oblique  line  on  the  ala  of  the  thyroid  cartilage. 
Action,  to  depress  the  larynx.     Nerve,  a  branch  from   the  communicating 
loop  between  the  descendens  and  communicans  noni. 
Thyro-hyoid,'^  from  the   oblique   line   on  the   thyroid   cartilage, — into   the 
body  and  greater  cornu  of  the  hyoid  bone.     Action,  to  elevate  the  larynx. 
Nerve,  hypoglossal. 
Omo-hyoid,^^ '» from  the  upper  border  of  the   scapula    and   the  transverse 
ligament, — into  the  body  of  the  hyoid  bone.     It  has  a  tendon  in  its  centre 
which  is  bound  down  to  the  cartilage  of  the  1st  rib  by  a  loop  of  the  deep 
cervical  fascia.     Action,  to  depress  the  hyoid  bone,  and  draw  it  backwards. 
Nerve,  branch  from  the  communicating  loop  between  the  descendens  and 
communicans  noni. 
Digastric,   by  2  bellies,  the  posterior  one^   from  the  digastric  groove  of  the 
mastoid  process  of  the  temporal  bone;  the  anterior^  from  a  fossa  on  the 
inner  surface  of  the  inferior  maxillary,  near  its  symphysis, — into  a  central 
tendon  ^  which  perforates  the  stylo-hyoid  muscle,  and  is  bound  down  to  the 
body  of  the  hyoid  bone  by  an  aponeurotic  loop.     Action,  to  raise  the  hyoid 
bone  and  tongue.  Nerves,  facial,  and  mylo-hyoid  branch  of  the  inferior  dental. 
Stylo-hyoid,*  from  the  styloid  process  of  the  temporal  bone  near  its  base,— 
into  the  body  of  the  hyoid  bone.     Action,  to  elevate  and  retract  the  hyoid 
bone.     Nerve^  facial.     This  muscle  is  perforated  by  the  digastric. 


MUSCLES    OF   THE   NECK.  "/S 

Mylo-hyoid,'*  from  the  mylo-hyoid  ridge  of  the  lower  jaw, — into  the  body  of 
the  hyoid  bone  and  a  fibrous  raphe  in  the  median  line  running  from  the  hyoid 
bone  to  the  chin.  Action,  elevates  the  hyoid  bone  and  draws  it  forwards, 
also  forms  the  floor  of  the  mouth.  Nerve,  mylo-hyoid  branch  of  inferior 
dental. 

Genio-hyoid,^  from  the  inferior  genial  tubercle  of  the  inferior  maxillary, — 
into  the  body  of  the  hyoid  bone.  Action,  same  as  the  mylo- hyoid.  Nerve, 
hypoglossal. 

Genio-hyo-glossuSjy^-iJ^^  the  superior  genial  tubercle  of  the  inferior  maxillary, 
— into  the  body  of  the  hyoid  bone,  the  side  of  the  pharynx,  and  the  whole 
length  of  the  under  surface  of  the  tongue,  forming  a  fan-like  muscle.  Action, 
to  retract  and  protrude  the  tongue.     Nerve,  hypoglossal. 

Hyo-glossus^  (the  basio-kerato-chondro-glossus),  from  the  body  of  the  hyoid 
bone,  its  lesser  cornu,  and  the  whole  length  of  its  greater  cornu, — into  the 
side  of  the  tongue.  Action,  to  draw  down  the  side  of  the  tongue.  Nerve, 
hypoglossal. 

Stylo-glossus,^  from  the  styloid  process  and  the  stylo-maxillary  ligament, — 
into  the  side  of  the  tongue  and  the  hyo-glossus  muscle.  Action,  to  elevate 
and  retract  the  tongue.     Nerve,  hypoglossal, 

Lingualis,  lies  between  the  hyo-glossus  and  the  genio-hyo-glossus,  from  the 
base  to  the  tip  of  the  tongue,  along  its  under  surface ;  some  of  its  fibres  being 
attached  to  the  hyoid  bone.  Action,  to  elevate  the  centre  of  the  tongue. 
Nerve,  chorda  tympani. 

Inferior  Constrictor,  from  the  sides  of  the  cricoid  and  thyroid  cartilages, — 
into  the  fibrous  raph6  of  the  pharynx.  Action,  to  contract  the  pharyngeal 
calibre.  Nerves,  glosso-pharyngeal,  pharyngeal  plexus,  and  external  laryn- 
geal. 

Middle  Constrictor,  from  the  cornua  of  the  hyoid  bone  and  the  stylo-hyoid 
ligament, — into  the  pharyngeal  raph6.  Action,  to  constrict  the  pharynx. 
Nerves,  glosso-pharyngeal,  pharyngeal  plexus. 

Superior  Constrictor,  from  the  lower  third  of  the  margin  of  the  internal 
pterygoid  plate  and  its  hamular  process,  the  contiguous  part  of  the  palate 
bone,  the  tendon  of  the  tensor  palati,  the  pterygo-maxillary  ligament,  part 
of  the  alveolar  process  of  the  lower  jaw  and  the  side  of  the  tongue, — into 
the  pharyngeal  raph6  and  the  pharyngeal  spine  of  the  occipital  bone. 
Action,  to  constrict  the  pharynx.  Nerves,  glosso-pharyngeal,  pharyngeal 
plexus. 

Stylo -pharyngeus,^*'  from  the  inner  side  of  the  base  of  the  styloid  process,^ 
into  the  constrictor  and  palato-pharyngeus   muscles,  and  the  thyroid  car- 
7 


74  ANATOMY. 

tilage.     Action,  to  elevate  the  pharynx.     Nei-ves,  glosso-pharyngeal,  pharyn- 
geal plexus.    The  former  nerve  crosses  this  muscle  in  passing  to  the  tongue. 

Levator  Palati,  from  the  under  surface  of  the  apex  of  the  petrous  portion  of 
the  temporal  bone  and  from  the  Eustachian  tube, — into  the  posterior  surface 
of  the  soft  palate.  Action,  to  elevate  the  soft  palate.  Nerve,  facial,  through 
the  Vidian  and  petrosal. 

Tensor  Palati,  from  the  scaphoid  fossa  of  the  sphenoid  bone  and  the  Eusta- 
chian tube, — reflected  around  the  hamular  process, — into  the  anterior  surface 
of  the  soft  palate,  and  the  horizontal  portion  of  the  palate  bone.  Action,  to 
tense  the  palate.     Nerve,  a  branch  from  the  otic  ganglion. 

Azygos  Uvulae,  frorn  the  posterior  nasal  spine  of  the  palate  bone,  and  from 
the  soft  palate, — into  the  uvula.  Action,  possibly  to  raise  the  uvula.  Nerve, 
facial,  through  the  Vidian  and  petrosal.  This  muscle  is  wrongly  named,  as 
it  is  double. 

Palato-glossus  (anterior  pillar  of  the  fauces),  from  the  anterior  surface  of  the 
soft  palate  laterally, — into  the  side  and  dorsum  of  the  tongue.  Action,  con- 
strictor isthmi  faucium.     Nerves,  palatine  branches  of  Meckel's  ganglion. 

Palato-pharyngeus  (posterior  pillar  of  the  fauces),  from  the  soft  palate, — into 
the  side  of  the  pharynx  and  the  posterior  border  of  the  thyroid  cartilage, 
having  joined  the  stylo-pharyngeus.  Action,  to  close  the  posterior  nares. 
Nerves,  palatine  branches  from  Meckel's  ganglion. 

Rectus  Capitis  Anti^cus  Major,  from  the  anterior  tubercles  of  the  transverse 
processes  of  the  3d,  4th,  5th,  and  6th  cervical  vertebrae  by  4  slips, — into  the 
basilar  process  of  the  occipital  bone.  Action,  to  flex  the  head.  Nerves, 
sub-occipital  and  deep  branches  of  cervical  plexus.  This  muscle  is  a  con- 
tinuation of  the  scalenus  anticus. 

Rectus  Capitis  Anti^cus  Minor,  from  the  anterior  surface  of  the  lateral  mass 
of  the  atlas,  and  the  root  of  its  transverse  process, — into  the  basilar  process 
of  the  occipital  bone.  Action,  to  flex  the  head.  Nerves,  sub-occipital  and 
deep  branches  of  the  cervical  plexus. 

Rectus  Lateralis,  from  the  upper  surface  of  the  transverse  process  of  the  atlas, 
— into  the  jugular  process  of  the  occipital  bone.  Action,  to  draw  the  head 
laterally.     Nerve,  sub-occipital. 

Longus  Colli,  3  portions, — the  superior  oblique,  from  the  anterior  tubercles  of 
the  transverse  processes  of  the  3d,  4th,  and  5th  cervical  vertebrae,  into  a 
tubercle  on  the  anterior  arch  of  the  atlas : — inferior  oblique,  from  the  bodies 
of  the  first  2  or  3  dorsal  vertebrae,  into  the  transverse  processes  of  the  5th 
and  6th  cervical ; — vertical  portion  from  the  bodies  of  the  lower  3  cervical 
and  upper  3  dorsal  vertebrse,  to  the  bodies  of  the  2d,  3d,  and  4th  cervical. 


MUSCLES    OF   THE   LARYNX    AND    EPIGLOTTIS.  76 

Action,  to  flex  the  cervical  vertebrae  and  slightly  to  rotate  them.  NerveSy 
branches  from  the  lower  cervical. 

Scalenus  KnXVzv&i^  from  a  tubercle  on  the  upper  surface  of  the  ist  rib, — 
into  the  transverse  processes  of  the  cervical  vertebrse,  from  the  3d.  to  the  6th 
inclusive.  Action,  to  flex  the  neck  laterally,  or  to  raise  the  1st  rib.  Nerves ^ 
branches  from  the  lower  cervical.     (See  Fig.  38.) 

Scalenus  Medius,^^  from  the  upper  surface  of  the  1st  rib,  behind  the  sub- 
clavian groove, — into  the  transverse  processes  of  the  lower  6  cervical 
vertebrse.  Action,  same  as  scalenus  anticus.  Nerves,  branches  from  the 
lower  cervical. 

Scalenus  Posti'cus,^^  from  the  outer  surface  of  the  2d  rib, — into  the  posterior 
tubercles  on  the  transverse  processes  of  the  lower  2  or  3  cervical  vertebrae. 
Action,  to  flex  the  neck  laterally,  or  to  elevate  the  2d  rib.  Nerves,  branches 
from  lower  cervical. 

MUSCLES   OF  THE  LARYNX  AND   EPIGLOTTIS. 

Crico-thyroid,  from  the  front  and  side  of  the  cricoid  cartilage, — into  the  lower 

and  inner  borders  of  the  thyroid  cartilage.     Action,  to  elongate  and  make 

tense  the  vocal  chords.     Ner^e,  superior  laryngeal. 
Crico-arytenoideus  Posticus,  from  the  cricoid  cartilage  posteriorly, — into  the 

outer  angle  of  the  base  of  the  arytenoid  cartilage.     Action,  to  rotate  the 

arytenoid  cartilages  outwards  and  open  the  glottis,  while  keeping  the  vocal 

chords  tense.     Nerve,  recurrent  laryngeal. 
Crico-arytenoideus  Lateralis,  from  the  upper  border  of  the  cricoid  cartilage 

laterally, — into   the    outer   angle  of   the  base  of   the  arytenoid    cartilage. 

Action,  to  rotate  the  arytenoid    cartilages  inwards  and  close  the  glottis. 

Nerve,  recurrent  laryngeal. 
Th3rro-arytenoideus,/rcw  the  receding  angle  of  the  thyroid  cartilage  and  the 

crico-thyioid  membrane, — into  the  base  and  anterior  surface  of  the  arytenoid 

cartilage.     Action,  to  shorten  and  relax  the  vocal  chords  by  approximating 

the  cartilages.     Nerve,  recurrent  laryngeal. 
Arytenoideus,  from  the  posterior  surface  and  outer  border  of  one  arytenoid 

cartilage, — into  the  corresponding  parts  of  the  opposite  cartilage,  filling  up 

the  posterior  concave  surface  of  these  cartilages.     Action,  by  approximating 

the  arytenoids,  to  close  the  back  part  of  the  glottis.     Nerves,  superior  and 

recurrent  laryngeal. 
riiyro-epiglottideus, /r^w  the  inner  surface  of  the  thyroid  cartilage, — m/^tha 

margin  of  the  epiglottis  and  the  aryteno-epiglottidean  fold.     Action,  a  de 

pressor  of  the  epiglottis.     Nerve,  recurrent  laryngeal. 


76  ANATOMY. 

Aryteno-epiglottideus  Superior,  from  the  apex  of  the  arytenoid  cartilage,— 
into  the  aryteno-epiglottidean  folds.  Action^  to  constrict  the  superior  laryn- 
geal aperture.     Nerve,  recurrent  laryngeal. 

Aryteno-epiglottideus  Inferior,  from  the  arytenoid  cartilage  anteriorly, — int6 
the  sacculus  laryngis  and  the  margin  of  the  epiglottis.  Action,  to  compress 
the  sacculus  laryngis.     Nerve,  recurrent  laryngeal. 

MUSCLES  OF  THE   BACK. 
First  layer  (2) — Trapezius.     Latissimtis  Dor  si. 

Second  layer  (3) — Levator  Anguli  Scapulce.    Rhomboideus  Major  and  Minor, 
Third  layer  (3) — Serratus  Posti'cus  Superior.     Serratus  Posticus  Inferior. 

Splenius  Capitis  et  Colli. 
Fourth  layer  (11) — in  4  sets,  viz. — 

Lumbar  ( i ) — Erector  Spince. 
External  (3).  Middle  (3).  Internal  (4). 

Sacro  lumbalis.  Longissimus  Dorsi.  Spinalis  Dorsi. 

Musculus  Accessorius  Transversalis  Colli.  Spinalis  Colli. 

ad  Sacro-lumbalem.  Trachelo-mastoid.  Biventer  Cervicis. 

Cervicalis  Ascendens.  Complexus. 

Fifth  layer  (12) — 6  having  the  word  spinal  in  them,  viz. — 
Semi- spinalis  Dorsi.  Inter-transversales. 

Semi-spinalis  Colli.  Rectus  Capitis  Posti'cus  Major. 

Multifidus  Spince.  Rectus  Capitis  Posticus  Minor. 

Rotatores  Spines.  Obliquus  Capitis  Superior, 

Supra-spinales.  Obliquus  Capitis  Inferior. 

Inter-spinales.  Extensor  Coccygis. 

Trapezius,^  from  the  inner  third  of  the  superior  curved  line  of  the  occipital 
bone,  the  ligamentum  nuchae,^  the  spinous  processes  of  the  last  cervical  and 
all  the  dorsal  vertebrae,  and  the  supra-spinous  ligament, — into  the  outer  third 
of  the  posterior  border  of  the  clavicle,  the  superior  margin  of  the  acromion 
process,  the  whole  length  of  the  superior  border  of  the  spine  of  the  scapula,^ 
and  a  tubercle  at  its  inner  extremity.  Action,  to  draw  the  head  backwards. 
Nerves,  spinal  accessory,  cervical  plexus. 
Ligamentum  NucujEjfrom  the  external  occipital  protuberance, — to  the  spines 

of  the  cervical  vertebrae,  from  the  2d  to  the  7th  inclusive. 
Latissimus  Dorsi,*  by  an  aponeurosis  from  the  spines  of  the  6  lower  dorsal 
and  the  lumbar  and  sacral  vertebrae,  the  supra-spinous  ligament,  the  crest 
of  the  ilium,  and  the  3  or  4  lower  ribs, — into  the  bicipital  groove  of  the 
humerus.  Action,  the  cursor  ani  muscle,  drawing  the  arm  downward? 
and  backwards ;  or  raising  the  lower  ribs  and  drawing  the  trunk  forwards 
NerveSy  the  subscapular. 


MUSCLES   OF  THE   BACK. 


77 


Levator  Angfuli  ScapuIsBj^o  by  4  slips  from  the  transverse  processes  of  3  or 
4  upper  cervical  vertebrae, — into  the  posterior  border  of  the  scapula.  Action, 
as  named.     Nerves,  branches  from  the  5th  cervical  and  the  cervical  pl^*us. 

Fig.  39. 


Rhomboideus  Minor,^i/r<?w  the  ligamentum  nuchae  and  spines  of  the  7th 
cervical  and  1st  dorsal  vertebrae, — into  the  smooth  surface  at  the  root  of  the 
spine  of  the  scapula.  Action,  to  draw  the  scapula  backwards  and  upwards. 
Nenie,  5th  cervical. 

Rhomboideus  Major.^'y)^^^  t]^e  spines  of  the  4  or  5   upper  dorsal  vertebra? 
and  the  supra-spinous  ligament, — into  the  scapula  at  the  root  of  its  spine 
and  inferior  angle,  by  a  tendinous  arch.     Action,  to  draw  the  scapula  up 
wards  and  backwards.     Nerve,  5th  cervical. 
7* 


'S  ANATOMY. 

Serratus  Posti^cus  Superior, /r^w  the  ligamentum  nuchae,  and  spines  of  the 
7th  cervical  and  2  or  3  upper  dorsal  vertebrae, — in/o  the  upper  borders  of 
the  2d,  3d,  4th,  and  5th  ribs,  by  4  digitations.  Action,  to  raise  ribs  in  in- 
spiration.    Nerves,  external  posterior  branches  of  the  cervical  nerves. 

Serratus  Posti^cus  Inferior,!^  from  the  spines  of  the  last  2  dorsal  and  first  3 
lumbar  vertebrae, — into  the  lower  borders  of  the  4  lower  ribs,  by  4  digi- 
tations. Action,  to  depress  these  ribs  in  expiration.  Nerves,  external 
branches  of  the  dorsal  nerves. 

Splenius  Capitis  '^  et  Q.oVi\}^  from  the  lower  half  of  the  ligamentum  nuchae, 
the  last  cervical  and  6  upper  dorsal  spines,  and  the  supra-spinous  ligament, 
— the  S.  capitis  into  the  mastoid  process  and  a  rough  surface  below  the  supe- 
rior curved  line  of  the  occipital  bone, — the  S.  colli  into  the  transverse  processes 
of  the  3  or  4  upper  cervical  vertebrae.  Action,  to  draw  the  head  backwards 
and  the  neck  erect.    Nerves,  external  posterior  branches  of  the  cervical  nerves. 

Erector  ^^\n?e.}  from  the  sacro-iliac  groove,  and  by  the  lumbo-sacral  tendon 
from  the  sacral,  lumbar  and  3  lower  dorsal  spines,  the  iliac  crest,  and  the 
posterior  eminences  of  the  sacrum, — divides  into  the  sacro-lumbalis^  and 
longissimus  dorsi^  muscles.  Action,  to  erect  the  spine  and  bend  the  trunk 
backwards.     N'erves,  external  posterior  branches  of  the  lumbar  nerves. 

Sacro-lumbalis,'  from  the  erector  spinae, — into  the  angles  of  the  6  lower 
ribs.     Action,  as  the  erector  spinae.     Nerves,  branches  of  the  dorsal. 

Musculus  Accessorius  ad  Sacro-lumbalem,'^  from  the  angles  of  6  lower 
ribs, — into  the  angles  of  6  upper  ribs.  Action,  as  the  erector  spinae.  Nerves, 
branches  of  the  dorsal. 

Cervicalis  Ascendens,5  from  the  angles  of  4  or  5  upper  ribs, — into  the 
transverse  processes  of  the  4th,  5th,  and  6th  cervical  vertebrae.  Action^ 
to  keep  the  neck  erect.     Nerves,  branches  of  the  cervical. 

Longissimus  Dorsi,^  from  the  erector  spinae, — into  the  transverse  and 
articular  processes  of  the  lumbar  vertebrae,  into  the  tips  of  the  transverse 
processes  of  all  the  dorsal  vertebrae,  and  into  from  7  to  ii  ribs  between 
their  tubercles  and  angles.  Action,  as  the  erector  spinae.  Nerves,  branches 
of  the  lumbar  and  dorsal  nerves. 

Transversalis  Colli,^  from  the  transverse  processes  of  the  3d,  4th,  5th,  and 
6th  dorsal  vertebrae, — into  the  transverse  processes  of  the  5  lower  cervical.^ 
Action,  to  keep  the  neck  erect.     Nerves,  cervical  branches. 

Trachelo-mastoid,''/rc/;z  the  transverse  processes  of  the  3d,  4th,  5th,  and  6th 
dorsal  vertebrae,  and  the  articular  processes  of  the  3  or  4  lower  cervical, — 
into  the  posterior  margin  of  the  mastoid  process.  Action,  to  steady  the 
head.     Nerves,  branches  of  the  cervical. 


MUSCLES   OF   THE   BACK. 


7& 


Spinalis  Dorsi,  from  the  last  2  dorsal  and 
first  2  lumbar  spines, — into  all  the  remaining 
dorsal  spines.  Action,  to  erect  the  spinal 
column.     Nerves^  branches  of  the  dorsal. 

Spinalis  Colli, /r^;/z  the  5th  and  6th  cervical 
spines,  sometimes  from  the  1st  and  2d 
dorsal, — into  the  spine  of  the  axis,  or  the 
3d  and  4th  cervical  spines.  Action,  to 
steady  the  neck.  Nerves,  branches  of  the 
cervical.  [This  muscle  is  frequently  ab- 
sent.] 

Biventer  Cervicis,  from  the  transverse  pro- 
cesses of  2  to  4  upper  dorsat  vertebrae, — 
into  the  superior  curved  line  of  the  occipi- 
tal bone.  [Is  but  a  portion  of  the  com- 
plexus  muscle.] 

Complexus,8  by  7  tendons  from  the  tips  of 
the  transverse  processes  of  the  7th  cervical 
and  3  upper  dorsal  vertebrae,  and  from  the 
articular  processes  of  the  4th,  5th,  and  6th 
cervical, — into  the  inner  depression  between 
the  curved  lines  of  the  occipital  bone.  Ac- 
tion, to  retract  and  rotate  the  head,  NerveSy 
suboccipital,  great  occipital,  and  branches 
of  the  cervical  nerves. 

Semispinalis  Dorsi,^"  from  the  transverse 
processes  of  the  dorsal  vertebrae,  from 
about  the  5th  to  the   i  ith, — into  the  last  2 

cervical  and  4  upper  dorsal   spines.     Action,  to  erect  the  spinal  column. 
Nerves,  branches  of  the  dorsal  nerves. 

Semispinalis  Colli,"  from  the  transverse  processes  of  the  4  upper  dorsal 
vertebrae,  and  the  articular  processes  of  the  4  lower  cervical, — into  the  2d, 
3d,  4th,  and  5th  cervical  spines.  Action,  to  erect  the  spinal  column.  Nerves^ 
branches  of  the  cervical. 

Multifidus  Spinae,^^  from  the  back  of  the  sacrum,  posterior  superior  spine  of 
the  ilium,  posterior  sacro-iliac  ligaments,  articular  processes  of  lumbar  and 
cervical  vertebrae,  and  the  transverse  processes  of  the  dorsal, — into  the 
laminae  and  spines  of  the  next  4  vertebrae  above.  Action,  to  erect  and  rotate 
the  spinal  column.     Nerves,  posterior  spinal  branches. 


80  ANATOMY. 

Rotatores  Spinse  (ii),  from  the  transverse  processes  of  the  dorsal  vertebrae, 
from  the  2d  to  the  1 2th  inclusive, — each  into  the  lamina  of  the  next  dorsal 
vertebrae  above.  Action,  to  rotate  the  spinal  column.  Nerves,  branches  of 
the  dorsal, 

Bupra-spinales,  lie  on  the  spinous  processes  in  the  cervical  region.  Nerves, 
branches  of  the  cervical. 

Inter-spinales  placed  in  pairs  between  the  spines  of  contiguous  vertebrae,  6 
pairs  in  the  cervical  region,  3  in  the  dorsal,  4,  sometimes  6,  in  the  lumbar. 
Nerves,  posterior  spinal  branches. 

Inter-txansversales,i8  placed  between  the  transverse  processes  of  conti^- 
ous  vertebrae,  7  in  the  cervical  region,  12  in  the  dorsal,  and  4  in  the  lumbar. 
Nerves,  posterior  spinal  branches. 

Rectus  Capitis  Posti^cus  Major,^^  from  the  spine  of  the  axis, — into  the  infe- 
rior curved  line  of  the  occipital  bone  and  the  surface  below.  Action,  to 
rotate  the  head.     Nerves,  sub-  and  great  occipital. 

Rectus  Capitis  Posti'cus  Minor,^^  from  the  tubercle  on  the  posterior  arch 
of  the  atlas, — into  a  rough  surface  between  the  foramen  magnum  and  the 
inferior  curved  line  of  the  occipital  bone.  Action,  to  draw  the  head  back- 
wards.    Nerves,  sub-  and  great  occipital. 

Obliquus  Capitis  Inferior,i5  from  the  spinous  process  of  the  axis, — almost 
horizontally  to  the  transverse  process  of  the  atlas.  Action,  to  rotate  the 
atlas  and  cranium.     Nerves,  sub-  and  great  occipital. 

Obliquus  Capitis  Superior,^*  from  the  transverse  process  of  the  atlas; — 
upwards  and  inwards  into  the  occipital  bone  between  the  curved  lines. 
Action,  draws  the  head  backwards.     Nerves,  sub-  and  great  occipital. 

Extensor  Coccygis,  from  the  last  bone  of  the  sacrum  or  first  of  the  coccyx, — 
into  the  lower  part  of  the  coccyx,  posteriorly.  Action,  as  named.  Nerves, 
posterior  sacral  branches. 

MUSCLES  OF  THE  ABDOMEN. 

External  Oblique,^^  fj-om  8  lower  ribs  by  8  fleshy  digitations, — into  the  an- 
terior half  of  the  outer  lip  of  the  crest  of  the  ilium,  and  by  a  broad  aponeu- 
rosis," into  the  ensiform  cartilage,  linea  alba,  symphysis,  and  spine  of  the 
pubes,  and  the  pectineal  line.  Its  aponeurosis  is  continuous  with  that  of  the 
pectoralis  major  above,  and  below  it  forms  Poupart's  '*  and  Gimbernat's 
ligaments,  and  by  the  separation  of  its  fibres,  the  external  abdominal  ring.^* 
Action,  to  compress  the  viscera,  and  flex  the  thorax  on  the  pelvis,  and  vice 
versd.     N'erves,  lower  intercostal,  ilio-hypogastric,  and  ilio-inguinal. 

Internal  OhMc^Q,^^  from  the  lumbar  fascia,  the  anterior  two-thirds  of  the 
middle  lip  of  the  crest  of  the  ilium,  and  the  outer  half  of  Poupart's  liga- 


MUSCLES   OF  THE  ABDOMEN. 


81 


ment, — into  the  cartilages  of  4  lower  ribs  ;  by  its  aponeurosis  into  the  linea 
alba;  and  leaving  an  arched  border^'*  over  the  spermatic  cord,  by  the  con- 
joined tendon^^  with  the  transversalis  into  the  pubic  crest  and  the  pectineal 
line.  Its  aponeurosis  splits  at  the  rectus  abdominis  for  its  upper  three- fourths, 
one  layer  passing  in  front,  the  other  behind  that  muscle,  to  unite  again  at  the 
linea  alba;  for  its  lower  one-fourth  it  passes  in  front  of  the  rectus.  Action 
and  Nerves,  same  as  the  external  oblique. 

Fig.  41. 


Transversalis,  from  the  outer  one-third  of  Poupart's  ligament,  the  anterior 
two-thirds  of  the  inner  lip  of  the  crest  of  the  ilium,  the  cartilages  of  6  lower 
ribs,  and  an  aponeurosis  from  the  spines  and  transverse  proeesses  of  the 
lumbar  vertebras, — by  its  aponeurosis  into  the  linea  alba,  and  by  the  con- 
joined tendon^^  with  the  internal  oblique,  into  the  pubic  crest  and  the 
pectineal  line.  Its  aponeurosis  passes  behind  the  rectus  abdominis  for  its 
upper  three-fourths,  in  front  of  that  muscle  for  its  lower  one-fourth. 

F 


82  ANATOMY. 

Lumbar  Fascia,  or  vertebral  aponeurosis  of  the  transversalis,  divides  into  j 
leaflets,  the  anterior  and  middle  being  attached  to  the  apices  of  the  transverse 
processes  of  the  lumbar  vertebras,  the  posterior  leaflet  to  the  apices  of  their 
spines.  The  anterior  and  middle  leaflets  enclose  the  quadratus  lumborum 
muscle,  the  middle  and  posterior  enclose  the  erector  spinge. 

Rectus  Abdominis,^6  by  2  tendons  from  the  pubic  crest  and  the  ligaments 
covering  the  symphysis, — into  the  cartilages  of  the  5th,  6th,  and  7th  ribs.  It 
lies  in  a  sheath  formed  by  the  aponeuroses  of  the  internal  oblique  and  trans- 
versalis muscles  for  its  upper  three-fourths,  and  is  crossed  by  2  to  5  tendinous 
lines,  the  Linece  Transversce.  At  its  outer  border  is  a  similar  line  placed 
vertically,  the  Linea  Semilunaris,  formed  by  the  aponeurosis  of  the  internal 
oblique  at  its  point  of  division.  Action,  to  flex  the  thorax  on  the  pelvis  and 
vice  versa,  also  to  compress  the  abdominal  viscera.  Nerves,  same  as  the 
external  oblique. 

Pyramidalis,^^  lies  in  front  of  the  rectus,  but  in  the  same  sheath,  arises  from 
the  front  of  the  pubic  bone  and  the  anterior  pubic  ligament, — into  the  linea 
alba,  half-w^ay  to  the  umbilicus.  Action,  a  tensor  of  the  linea  alba.  Nerves, 
same  as  the  external  oblique. 

Quadratus  Lumborum,^^  p^k-  ^  from  the  ilio-lumbar  ligament,  adjacent  2  inches 
of  the  crest  of  the  ilium,  and  transverse  processes  of  the  lower  3  lumbar  ver- 
tebrae,— into  one-half  of  the  low^er  border  of  the  last  rib,  and  the  transverse 
processes  of  the  last  3  lumbar  vertebrae.  Action,  to  flex  the  thorax  laterally 
on  the  pelvis  and  %nce  versa.     Nerves,  anterior  branches  of  the  lumbar. 

MUSCLES   OF  THE  THORAX. 

External  Intercostals  (11),  each  from  the  outer  lip  of  the  groove  in  the  in- 
ferior costal  border, — into  the  upper  border  of  the  next  rib  below,  directed 
obliquely  downwards  and  forwards.  Action,  to  raise  and  evert  the  ribs  in 
inspiration.     Nerves,  intercostal. 

Internal  Intercostals  (11),  each  from  the  inner  lip  of  the  groove  in  the  in- 
ferior costal  border, — into  the  upper  border  of  the  rib  below,  directed 
obliquely  downwards  and  backwards.  Action,  at  sides  of  thorax  to  depress 
the  ribs  in  expiration ;  anteriorly  they  raise  the  costal  cartilages.  N'erves, 
intercostals. 

Xnfra-costales  (10),  obliquely  from  inner  surface  of  i  rib, — into  the  inner 
surface  of  the  ist,  2d,  or  3d  rib  below.  Action,  muscles  of  inspiration. 
Nerves,  intercostal. 

Triangularis  Stemi,  from  the  inner  surface  of  the  ensiform  cartilage,  inner 
surfaces  of  costal  cartilages  of  3  or  4  lower  true  ribs,  and  lower  sides  of  the 


MUSCLES    OF   THE   PERINEUM. 


Fig.  42. 


stei-num, — into  the  lower  border  and  inner  surfaces  of  the  2d,  3d,  4th,  and 
5th  costal  cartilages.  Action,  to  draw  down  the  cartilages  in  expiration. 
iVerves,  intercostal. 

Levatores  Costarum,^''  fig.  40  (12),  Q2ich.fro?n  the  transverse  process  of  a  dorsal 
vertebra, — into  the  upper  surface  of  the  next  rib  below,  near  its  angle. 
Action,  to  raise  the  ribs.     Nerves,  intercostal. 

Diaphragm,  from  the  ensiform  cartilage,*  inner  surfaces  of  6  or  7  lower  ribs, 
iigamenla  arcuata,^  and  by  its  crura^  ^'^  from  the  bodies  of  the  lumbar  ver- 
tebrae, from  the  2d  to 
the  4th  on  the  right 
side,  the  2d  and  3d  on 
the  left, — into  the  cen- 
tral or  cordiform  ten- 
don.2  3  Action,  the 
great  muscle  of  respi- 
ration and  expulsion. 
Nerve,  the  phrenic. 

Openings  of  the  Dia- 
phrag7n.  The  Aortic}^ 
in  the  middle  line  pos- 
teriorly, and  behind 
the  diaphragm;  trans- 
mits the  aorta,  vena 
azygos  major,  and  tho- 
racic duct,  occasionally 
the     left     sympathetic 

nerve.      The    (Esopha-  '^" 

geal}"^  in  the  muscular  structure,  transmits  the  oesophagus  and  the  pneumo- 
gastric  nerves.  The  Opening  for  the  Vena  CavdS^  is  the  highest,  and  has  4 
tendinous  margins.  The  Right  Crufi  transmits  the  sympathetic  and  greater 
and  lesser  splanchnic  nerves  of  that  side.  The  Left  Crus}^  the  greater  and 
lesser  splanchnic  nerves  of  the  left  side  and  the  vena  azygos  minor. 

Descent  of  the  Diaphragm.  Its  central  tendon  does  not  descend  during  in- 
spiration, being  connected  with  the  deep  cervical  fascia  by  the  fibrous 
pericardium. 


MUSCLES  OF  THE   PERINEUM. 

Sphincter  Ani,*  from  the  tip  of  the  coccyx  and  superficial  fascia, — into  the 
tendinous  centre  of  the  perineum.  Action,  to  close  the  anus.  Nerve, 
hemorrhoidal  branch  of  the  pudic. 


S4 


ANATOMY. 


Internal  Sphincter,  a  m.iscula<  ring,  half  an  inch  broad,  aljout  an  inch  from 
the  margin  of  the  anus;  is  an  aggregation  of  the  involuntary  circular  fibres 
or  the  intestine. 

Fig.  43. 


Sphincter  Tertius  of  Hyrtl,  frovi  the  sacrum,  encircling  the  rectum  about  4 

inches  above  the  anal  orifice.     [Demonstrated  by  Hyrtl,  Nelaton,  and  Vel- 

peau,  but  denied  by  most  anatomists.] 
Accelerator  Urinae,^  from  the  central  tendon  of  the  perineum  and  the  median 

raph6  in  front, — fibres    spread   over  the  bulb,  corpus  spongiosum,  corpus 

cavemosum,^'  and  dorsal  vessels.     Action,  to  accelerate  the  flovv^  of  urine, 

and  erect  the  penis.     Nerve,  perineal  branch  of  pudic. 
Erector  Penis,^  f->'om  the  inner  surface  of  the  tuberosity  of  the  ischium,  the 

crus  penis,  and  pubic  ramus, — into  the  crus  penis  laterally  and  inferiorly. 

Action,  to  maintain  erection.     Net^e,  perineal. 
Transversus  Perinei,-^  from  the  ascending  ramus  of  the  ischium, — into  the 

central  tendon  of  the  perineum.     Action,  to  drav^^  tense  the  central  tendon. 

A^erve,  perineal. 
Levator  An\,^from  the  body  and  ramus  of  the  pubes  posteriorly,  pelvic  fascia, 

and  the  spine  of  the  ischium, — into  the  tendinous  centre  of  the  perineum, 

sides  of  the  rectum  (and  vagina),  apex  of  the  coccyx,  and  a  fibrous  raphe 

extending  from  the  coccyx  to  the  anus.     Action,  to  support  the  lovs^er  end  of 

the  rectum  and  vagina  and  the  bladder,  and  assist  in  forming  the  floor  of  the 

pelvis.     Nei-ves,  inferior  hemorrhoidal  and  4th  sacral. 
Compressor  Urethrae,  from  the  upper  part  of  the  ramus  of  the  pubes, — into 

its  fellow^  of  the  opposite  side  after  encircling  the  membranous  portion  of  th» 

urethra.     Action,  stop-cock  muscle.     Nerve,  perineal. 


MUSCLES  OF  THE  SHOULDER  AND  ARM.  85 

Coccygeus,^/;--^?;^  the  spine  of  the  ischium  and  the  lesser  sacro-sciatic  liga- 
ment,— into  the  margin  of  the  coccyx  and  the  side'of  the  last  sacral  segment. 
Action,  to  support  the  coccyx,  and  close  the  outlet  of  the  pelvis  posteriorly. 
Nerve,  5th  sacral,  anterior  division. 

Sphincter  Vaginae  (in  the  female),  fj'om  the  central  tendon  of  the  perineum, 
— into  the  corpora  cavernosa  and  body  of  the  clitoris.  Represents  the  accel- 
erator urinae  of  the  male. 

Erector  Clitoridis  (in  the  female),  replaces  the  erector  penis. 

MUSCLES    OF  THE   SHOULDER   AND   ARM. 

Pectoralis  Major, /r^z??  the  sternal  one-half  of  the  clavicle,  by  an  aponeu- 
rosis from  the  front  of  the  sternum  as  low  as  the  6th  or  7th  rib,  the  cartilages 
of  all  the  true  ribs,  and  the  aponeurosis  of  the  external  oblique, — the  fibres 
converge,  cross  and  are  inserted  by  a  flat  tendon  into  the  external  bicipital 
ridge  of  the  humerus,  having  crossed  the  bicipital  groove.  Action,  to  draw 
the  arm  forwards  and  downwards ;  also  to  elevate  the  ribs  in  forced  inspira- 
tion.    Nerves,  anterior  thoracic. 

Pectoralis  Miuov^  from  the  3d,  4th,  and  5th  ribs,  and  the  intercostal  aponeu- 
rosis,— inro  the  coracoid  process  of  the  scapula.  Action,  to  depress  the 
point  of  the  shoulder,  also  to  elevate  the  ribs  in  forced  inspiration.  Nerves, 
anterior  thoracic. 

SvhcXsiw'wxs,  from  the  cartilage  of  the  1st  rib, — into  the  under  surface  of  the 
clavicle,  in  a  groove  about  its  middle  3d.  Action,  to  draw  the  clavicle 
downwards.     Nerve,  a  branch  from  the  5th  and  6th  cervical. 

Serratus  Magnus,  by  9  digitations/r^pw  the  8  upper  ribs  (the  2d  rib  having 
2)  and  from  the  intercostal  aponeurosis, — into  the  whole  length  of  the  inner 
margin  of  the  posterior  border  of  the  scapula.  Action,  to  elevate  the  rihs 
in  inspiration,  also  to  raise  the  point  of  the  shoulder.  In  lower  animals 
the  great  sling-muscle,  slinging  the  body  between  the  upper  extremities. 
Nerve,  posterior  thoracic. 

Deltoid, /rc';^  the  outer  one-third  of  the  anterior  and  superior  surfaces  of  the 
clavicle,  the  outer  margin  and  upper  surface  of  the  acromion,  and  the  whole 
lower  border  of  the  spine  of  the  scapula, — into  a  prominence  on  the  outer 
side  of  the  shaft  of  the  humerus,  about  its  middle.  Action,  to  raise  the  arm. 
Nerve,  circumflex. 

Subscapularis, /rcw  the  inner  two-thirds  of  the  subscapular  fossa, — into  the 
lesser  tuberosity  of  the  humerus.  Action,  to  rotate  the  head  of  the  humerus 
inwards.     Nerves,  subscapular. 

Supra-spinatus,yr(7w  the  inner  two-thirds  of  the  supra-spinous  fossa, — intf 
the  upper  facet  of  the  greater  tuberosity  of  the  humerus.     Action,  to  sup- 
port the  shoulder-joint,  and  to  raise  the  arm.     Nerve ^  supra-scapular. 
8 


86 


ANATOMY. 


Fig.  44. 


Infra-spinatus,  frotn  the  inner  two-thirds  of  the  infra-spinous  fossa, — inta 
the  middle  facet  on  the* greater  tuberosity  of  the  humerus.  Action,  to  rotate 
the  humerus  outwards.     Nerve,  supra-scapular. 

Teres  Minor,  from  the  upper  two-thirds  of  the  dorsal  surface  of  the  axillary 
border  of  the  scapula, — into  the  lowest  facet  on  the  greater  tuberosity  of 
the  humerus,  and  the  bone  below.  Actioji,  to  rotate  the  humerus  outwards. 
Nerve,  circumflex. 

Teres  Major,  from  the  dorsal  aspect  of  the  inferior  angle  of  the  scapula, — 
into  the  internal  bicipital  ridge  of  the  humerus.  Action,  to  assist  the  latis- 
simus  dorsi.     Nerve,  subscapular, 

Coraco-brachialis," /rcw  the  apex  of  the  coracoid  process^  of  the  scapula, 
— into  a  ridge  on  the  inner  side  of  the  shaft  of 
the  humerus,  about  its  middle.  Action,  elevates 
the  humerus  forwards  and  inwards.  Nerve,  mus- 
culo-cutaneous,  which  perforates  this  muscle. 

Bicepses  (Biceps  Flexor  Cubiti).  Long  head^ 
from  the  upper  margin  of  the  glenoid  cavity, 
short  head'^'^  from  the  apex  of  the  coracoid 
process,^  in  common  with  the  coraco-brachi- 
alis, — into  the  back  of  the  tuberosity  of  the 
radius,  and  the  fascia  of  the  forearm.^o 
Action,  to  flex  and  supinate  the  forearm,  and 
to  make  tense  its  fascia.  Nerve,  the  musculo- 
cutaneous. 

Brachialis  Anti^'cus,^^  from  the  lower  half  of 
the  shaft  of  the  humerus  anteriorly  and  later- 
ally, embracing  the  insertion  of  the  deltoid,^ — 
into  the  base  of  the  coronoid  process  of  the 
ulna.19  Action,  a  flexor  of  the  forearm. 
Nerves,  musculo-cutaneous  and  musculo-spiral. 

Tricepsifi  (Triceps  Extensor  Cubiti),  by  three 
heads,  the  outer  and  inner  from  the  posterior 
surface  of  the  shaft  of  the  humerus,  the  outer 
above,  the  inner  below  the  musculo-spiral 
groove;  the  middle  or  long  head  from  a  de- 
pression below  the  glenoid  cavity  of  the  scapula, 
— into  the  upper  end  of  the  olecranon  process 
of  the  ulna.  Action,  to  extend  the  forearm 
Nerve,  musculo-spiral. 


MUSCLES   OF  THE   FOREARM.  87 

Subanconeus,  from  the  humerus  above  the  olecranon  fossa, — into  the  poste- 
rior ligament  of  the  elbow-joint.  Action^  probably  a  tensor  of  the  ligament 
Nerve^  musculo-spiral. 

MUSCLES   OF  THE   FOREARM. 

Muscles  of  the  forearm  (20),  arranged  in  groups  of  five  and  threes.    (Pancoast.j 
Anteriorly,  5  flexors,  2  pronators,  i  tensor  of  palmar  fascia : — 
Flexor  Carpi  Radialis.  Pronator  Radii  Teres. 

Flexor  Carpi  Ulnaris.  Pronator  Quadratus. 

Flexor  Longus  Pollicis.  Palmaris  Longus. 

Flexor  Sublimis  Digitorum  Perforatus  Manis. 
Flexor  Profundus  Digitoru7?i  Perforans  Manis. 
Posteriorly  (12),  in  4  sets  of  threes: — 

Supinator  Longus.  Extensor  Indicis. 

Extensor  Carpi  Radialis  Longior.  Extensor  Communis  Digitorum, 

Extensor  Carpi  Radialis  Brevior,  Extensor  Minimi  Digiti. 

Extensor  Ossis  Metacarpi  Pollicis.  Extensor  Carpi  Ulnaris. 

Extensor  Primi  Internodii  Pollicis.  Anconeus. 

Extensor  Secundi  Internodii  Pollicis.        Supinator  Brcvis. 
Pronator  Radii  Teres,*  by  2  heads,  one  from  above  the  internal  condyle  of 
the  humerus,  the  common  tendon,  fascia,  and  the  intermuscular  septum ;  the 
other  from  the  inner  side  of  the  coronoid  process  of  the  ulna, — into  a  rough 
ridge  on  the  outer  side  of  the  shaft  of  the  radius,  about  its  middle.     Action^ 
to  pronate  the  hand.     Nerve,  median,  which  passes  between  the  2  heads 
of  the  muscle. 
Flexor  Carpi  Radialis,5yr^»?  the  internal  condyle  by  the  common  tendon,  the 
fascia,  and  intermuscular  septa, — into  the  base  of  the  metacarpal  bone  of  the 
index  finger.     Action,  to  flex  the  wrist.     Nerve,  median. 
Palmaris  Longus,syrf»/  the  same  origin  as  the  flexor  carpi  radialis, — ijito  the 
annular  ligament  and  the  palmar  fascia.*     Action,  to  make  the  palmar  fascia 
tense.     Nerve,  median. 
Flexor   Carpi   Ulnaris,^  by  2  heads,  one  from  the  internal  condyle  by  the 
common   tendon,  the  other  from  the  inner  margin  of  the   olecranon,  the 
upper  two-thirds  of  the  posterior  border  of  the  ulna,  and  the  intermuscular 
septum, — into  the  pisiform  bone,  the  annular  ligament,  and  the  base  of  the 
5th  metacarpal  bone.     Action,  to  flex  the  wrist.     Nerve,  ulnar. 
Flexor  Sublimis  Digitorum  (Perforatus),''  by  3  heads,  one  from  the  inner 
condyle  by  the  common  tendon,  the  internal  lateral  ligament,  and  the  inter 
muscular  septum;  the  2d  from  the  inner  side  of  the  coronoid  process;  the 
3d  from  the  oblique  line  of  the  radius, — into  the  lateral  margins  of  the  Siecon(( 


ANATOMY. 


^^^-  45  phalanges  by  4  tendons  which  are  split  for  the  passage 

of  the  deep  flexor  tendons.    Aclion,  to  flex  the  second 
phalanges.     Nerve,  median. 

Flexor  Profundus  Digitorum  (Perforans),  from  the 
upper  two-thirds  of  the  shaft  of  the  ulna,  a  de- 
pression on  the  inner  side  of  the  coronoid  process, 
and  the  interosseous  membrane, — into  the  bases  of 
the  last  phalanges,  by  4  tendons  which  perforate 
the  tendons  of  the  superficial  flexor.  Action,  to 
flex  the  phalanges.  Nerves,  ulnar,  and  anterior 
interosseous. 

Flexor  Longus  PoUicis,  from  the  upper  two-thirds 
of  the  shaft  of  the  radius,  and  the  interosseous 
membrane, — into  the  base  of  the  last  phalanx  of 
the  thumb,  which  it  flexes.  Nerve,  anterior  inter- 
osseous. 

Pronator  Quadratus,  from  the  oblique  line  on  the 
lower  one-fourth  of  the  ulna,  and  the  internal  body 
of  the  ulna, — into  the  lower  one-fourth  of  the  ex- 
ternal border  of  the  shaft  of  the  radius.  Action,  to 
pronate  the  hand.     A^erve,  anterior  interosseous. 

Supinator  Longus,^'  from  the  upper  two-thirds  of  the 
external  condyloid  ridge  on  the  humerus,  and  the 
intermuscular  septum, — into  the  base  of  the  styloid 
process  of  the  radius.  Action,  to  supinate  the  hand. 
Nerve,  musculo-spiral. 

Extensor  Carpi  Radialis  Longior,^  from  the  lower  one-third  of  the  external 
condyloid  ridge  on  the  humerus,  and  the  intermuscular  septum, — info  the 
base  of  the  metacarpal  bone  of  the  index  finger,^  on  its  radial  side.  Action, 
to  extend  the  wrist.     Nerve,  musculo-spiral. 

Extensor  Carpi  Radialis  Brevior,/  from  the  external  condyle  by  the  common 
tendon,  the  external  lateral  ligament,  and  the  intermuscular  septa, — into  the 
radial  side  of  the  base  of  the  3d  metacarpal  bone.i'  Action,  to  extend  the 
wrist.     Nerve,  posterior  interosseous. 

Extensor  Communis  Digitorum,'^  from  the  external  condyle  by  the  common 
tendon,  the  deep  foscia,  and  the  intermuscular  septa, — into  the  2d  and  3d 
phalanges  of  all  the  fingers,  by  3  tendons,  one  of  which  divides  into  two. 
Action^  to  extend  the  fingers.     Nerve,  posterior  interosseous. 


MUSCLES   OF  THE  FOREARM. 


8fi 


Fig.  46. 


Extensor  Minimi  Digiti,i  from  the  common  tender    and  the  intermusculai 

septa, — into  the  2d  and  3d  phalanges  of  the  little  finger,  with  the  tendon 

derived   from   the    common    extensor.      Action,  as 

named.     Nerve,  posterior  interosseous. 
Extensor  Carpi  Ulna.ns,j  from  the  common  tendon, 

the  middle  one-third  of  the  posterior  border  of  the 

ulna,  and  the  fascia  of  the  forearm, — into  the  base 

of  the  5th  metacarpal  bone.     Action,  to  extend  the 

wrist.     Nerve,  posterior  interosseous. 

Anconeus,'^ yj-^w  the  external  condyle  of  the  humerus, 
posteriorly, — itito  the  side  of  the  olecranon,  and 
upper  one-third  of  the  posterior  surface  of  the  shaft 
of  the  ulna.  Action,  to  extend  the  foreann.  Nerve, 
the  musculo-spiral. 

Supinator  Brevis,  from  the  external  condyle  of  the 
humerus,  the  external  lateral  and  orbicular  liga- 
ments, and  an  oblique  line  on  the  ulna, — into  the 
inner  surface  of  the  neck  of  the  radius,  the  outer 
edge  of  its  bicipital  tuberosity,  and  the  oblique  line. 
Action,  to  supinate  the  hand.  Nerve,  posterior  in- 
terosseous, which  pierces  it. 

Extensor  Ossis  Metacarpi  PoUicis,^*  from  the  pos- 
terior surfaces  of  the  shafts  of  the  radius  and  ulna, 
and  the  interosseous  ligament, — into  the  base  of  the 
metacarpal  bone  of  the  thumb.  Action,  to  extend 
the  thumb.     Nerve,  posterior  interosseous. 

Extensor  Primi  Intemodii  Pollicis,«  from  the  pos- 
terior surface  of  the  shaft  of  the  radius  and  the  in- 
terosseous  membrane, — into   the    base   of   the    1st 
phalanx  of  the  thumb.      Action,  to  extend  the  thumb, 
interosseous. 


Nerve ^  posterioi 


Extensor  Secundi  Intemodii  Pollicis,^  from  the  shaft  of  the  ulna  poste- 
riorly and  the  interosseous  membrane, — into  the  base  of  the  last  phalanx 
of  the  thumb.  Action,  to  extend  the  thumb.  Nerve,  posterior  inter- 
osseous. 

Extensor  Indicis,  from  the  shaft  of  the  ulna  posteriorly  and  the  interosseous 
membrane, — into  the  2d  and  3d  phalanges  of  the  index  finger  with  the 
tendon  of  the  common  extensor.    Action,  to  extend  the  index  finger.    Neni, 
posterior  interosseous. 
8* 


90  ANATOMY. 

FASCIA   OF   THE   HAND. 

Anterior  Annular  Ligament,  from  the  pisiform  and  unciform  bones, — u 
the  tuberosity  of  the  scaphoid  and  the  ridge  on  the  trapezium.  It  is  pierced 
by  the  tendon  of  the  flexor  carpi  radialis,  and  beneath  it  pass  the  tendons 
of  the  superficial  and  deep  flexors  and  the  flexor  longus  pollicis,  also  the 
median  nerve.  It  is  continuous  with  the  palmar  fascia  and  the  fascia  of  the 
forearm. 

Posterior  Annular  Ligament,^  froiii  the  ulna,  cuneiform,  and  pisiform 
bones  and  the  palmar  fascia, — to  the  margin  of  the  radius  and  the  ridges  on 
its  posterior  surface.  It  has  6  canals  for  the  passage  of  the  extensor  tendons, 
each  lined  by  a  synovial  membrane.  It  is  continuous  with  the  fascia  of  the 
forearm. 

Palmar  Fascia,  ensheathes  the  muscles  of  the  hand,  and  divides  into  slips  for 
the  four  fingers,  each  slip  dividing  and  forming  tendinous  arches  for  the 
passage  of  the  flexor  tendons. 

MUSCLES   OF  THE   HAND. 
Abductor  Pollicis,^^  from  the  ridge  of  the  trapezium  and  annular  ligament, — 

into  the  radial  side  of  the  base  of  the  1st  phalanx  of  the  thumb.     Action,  to 

draw  the  thumb  from  the  median  line.     Nerve,  median. 
Opponens  Pollicis,  from  the  palmar  surface  of  the  trapezium  and  annular 

ligament, — into  the  radial  side  of  the  metacarpal  bone  of  the  thumb,  for  its 

whole  length.     Action,  as  a  flexor  ossis  metacarpi  pollicis.     Nerve,  median. 
Flexor  Brevis  Pollicis,^^  fro7}t  the  trapezium,  annular  ligament,  trapezoid,  os- 

magnum,  base  of  the  3d  metacarpal,  and  the  sheath  of  the  tendon  of  the 

flexor  carpi  radialis, — into  both  sides  of  the  base  of  the  1st  phalanx  of  the 

thumb,  by  two  tendons,  each  of  which  has  a  sesamoid  bone  in  it.     Action, 

to  flex  the  thumb.     Nerves,  median  and  ulnar. 
Adductor  Y*o\\ic\s,  from  the  whole  palmar  surface  of  the  3d  metacarpal  bone, 

— into  the  ulnar  side  of  the  base  of  the  ist  phalanx  of  the  thumb,  and  the 

internal  sesamoid  bone.     Action,  to  draw  the  thumb  towards  the  median 

line.     Nerve,  ulnar. 
Thenar  Eminence,  or  ball  of  the  thumb,  is  formed  by  the  above-named  4 

muscles.     The  following  first  4  form  the  Hypo-thenar  Eminence. 
Palmaris  Brevis,!"  from  the  annular  ligament  and  palmar  fascia, — into  the 

skin  on  the  inner  border  of  the  palm  of  the  hand.     Action,  to  corrugate  the 

skin  of  the  hand.     Nerve,  ulnar. 
Abductor  Minimi  Digiti,  from  the  pisiform  bone  and  the  tendon  of  the  flexor 

carpi  ulnaris, — into  the  ulnar  side  of  the  base  of  the  ist  phalanx  of  the  little 

finger.     Action,  as  named.     Nerve,,  ulnar. 


MUSCLES   OF  THE   HIP  AND  THIGH.  91 

Flexor  Brevis  Minimi  "Digitiy/rom  the  tip  of  the  unciform  process  and  the 
annular  ligament, — inio  the  base  of  the  1st  phalanx  of  the  little  finger,  wiih 
the  preceding  muscle.     Action,  as  named.     Nerve^  ulnar. 

Opponens  Minimi  Digiti,  from  the  unciform  process  and  annular  ligament, — 
into  the  whole  ulnar  margin  of  the  5th  metacarpal  bone.  Action^  a  flexor 
of  the  5th  metacarpal  bone.     Nerve,  ulnar. 

Lumbricales  (4),  from  the  tendons  of  the  deep  flexor, — into  the  expanded 
tendons  of  the  common  extensor,  on  the  dorsi  of  the  phalanges.  Action, 
probably  to  flex  the  ist  phalanges.     Nerves^  median  and  ulnar. 

Dorsal  Interossei  (4),  by  2  heads  from  the  adjacent  sides  of  the  metacarpal 
bones, — into  the  bases  of  the  1st  phalanges  of  the  index,  middle,  and  ring 
fingers,  the  middle  finger  having  two.  Action,  abductors  of  the  fingers  from 
the  median  line.     Nerve,  ulnar. 

Palmar  Interossei  (3),  from  the  palmar  surfaces  of  the  2d,  4th,  and  5th  meta- 
carpal bones, — into  the  bases  of  the  ist  phalanges  of  the  same  fingers. 
Action,  adductors  of  the  fingers.     Nerve,  ulnar. 

MUSCLES  OF  THE  HIP  AND  THIGH.      * 

Psoas  Magnus," /r<9OT  the  bodies,  transverse  processes,  and  intervertebral 
substances  of  the  last  dorsal  and  all  the  lumbar  vertebrae, — into  the  lesser 
trochanter  of  the  femur,  by  a  common  tendon  with  the  iliacus.  Action,  to 
flex  and  rotate  the  femur  outwards,  also  to  flex  the  trunk  and  pelvis  on  the 
thigh.     Nerves,  anterior  lumbar  branches. 

Psoas  Parvus,  from  the  bodies  of  the  last  dorsal  and  first  lumbar  vertebrae, 
and  the  intervertebral  substance, — into  the  ilio-pectineal  eminence,  and  the 
iliac  fascia.  Action,  when  present  it  is  a  tensor  of  the  iliac  fascia.  Nerves, 
anterior  lumbar  branches. 

Iliacus,'®  from  the  iliac  fossa,  inner  margin  of  the  iliac  crest,  ilio-lumbar 
ligament,  base  of  the  sacrum,  anterior  spinous  processes  of  the  ilium  and 
the  notch  between  them,  and  from  the  capsule  of  the  hip-joint, — into  the 
outer  side  of  the  tendon  of  the  psoas  magnus.  Action,  the  same  as  the 
psoas  magnus.     Nerve,  anterior  crural. 

Kascia  Lata,  the  deep  fascia  of  the  thigh,  extends  from  Poupart's  ligament 
to  the  prominent  points  around  the  knee-joint,  and  from  the  margin  of  the 
sacrum  and  coccyx  around  the  limb  to  the  pubic  arch  and  pectineal  line. 
It  sends  two  strong  intermuscular  septa  down  to  the  linea  aspera,  and  con- 
tains the  Saphenous  Opening,  which  is  foitned  by  the  reflected  margins  of 
its  pubic  and  iliac  portions.  Pouparf  s  Ligament  is  made  by  the  knife,  and 
is  only  the  line  of  junction  between  the  aponeurosis  of  the  external  oblique 


92 


ANATOMY. 


muscle  and  the  fascia  lata ;  extending  from  the  anterior  superior  spine  of 
the  ilium  to  the  spine  of  the  pubic  bone. 


Fig.  47. 


Tensor  Vaginae  Femoris,*  from  the  anterior  part  o( 
the  outer  lip  of  the  iliac  crest,  and  the  anterioi 
superior  spinous  process, — info  the  fascia  lata  later- 
ally, for  one-fourth  down  the  thigh.  Action,  a 
tensor  of  the  fascia  lata.     Nerve,  superior  gluteal. 

Sartorius,*  from  the  anterior  superior  spine  of  the 
ilium  2  and  half  of  the  notch  below  it, — into  the 
upper  internal  surface  of  the  shaft  of  the  tibia. 
Action,  to  flex  and  cross  the  legs.  Nerve,  anterior 
crural. 

Quadriceps  Extensor,  includes  the  rectus,  vastus 
internus  and  externus,  and  the  crureus  muscles. 
Its  tendon  contains  the  patella. 

Rectus  Femoris,^  by  two  tendons,  the  Straight  from 
the  anterior  inferior  spine  of  the  ilium,  the  Reflected 
from  a  groove  above  the  brim  of  the  acetabulum, 
— into  the  tuberosity  of  the  tibia  by  the  tendon  9 
common  to  this  and  the  next  3  muscles.  Action,  to 
extend  the  leg.     Nerve,  anterior  crural. 

Vastus  Externus,'  from  the  anterior  border  of  the 
great  trochanter  and  the  whole  length  of  the  linea 
aspera, — into  tlie  tuberosity  of  the  tibia,  by  the 
common  tendon. 

Vastus  Internus  ^  and  Crureus  are  one  muscle,  arising 
from  the  inner  lip  of  the  linea  aspera  and  nearly 
the  whole  of  the  shaft  of  the  femur  in  front  and 
laterally  from  the  trochanters  down  to  within  the 
lower  one-fourth  of  the  bone, — into  the  tuberosity  of  the  tibia  by  the  common 
extensor  tendon.     Action,  to  extend  the  leg.     Nerve,  anterior  crural. 

Subcrureus,  from  the  lower  part  of  the  femur  anteriorly, — into  the  synovial 

pouch  behind  the  patella.     Action,  to  draw  up  the  synovial  sac.     Nerve, 

anterior  crural. 
QrsicWxs,^^  from  the  inner  margin  of  the  rami  of  the  pubes  and  ischium, — into 

the  inner  surface  of  the  shaft  of  the  tibia  below  the  tuberosity.     Action,  to 

flex  and  adduct  the  leg.     Nerve,  obturator. 
Pectineus,i2  fro7n  the  ilio-pectineal  line,  and  the  bone  in  front  thereof,  also 

from  an  expansion  of  Gimbernat's  ligament, — into  the  rough  line  extending 


MUSCLES   OF  THE   HIP  AND  THIGH. 


from  the  trochanter  minor  to  the  linea  aspera.     Action,  to  flex  the  thigh 

and  rotate  it  outwards.     Nerves^  obturator,  accessory  obturator,  and  anterior 

crural. 
Adductor   Longus,^3/r<?w  the  front  of  the  pubes, — into  the  middle  third  of 

the  linea  aspera.     Action,  to  adduct  the  thigh  and  flex  it.     Nerve,  obturator. 
Adductor  Brevis,  fro77i  the  descending  ramus  of  the  pubes, — into  the  upper 

part  of  the  linea  aspera.     Action,  to  adduct  and  flex  the   thigh.     Nervfy 

obturator. 

Adductor  Magnus,^*  from  the  rami  of  the  pubes  and  ischium,  and  the  outer 
margin  and  under  surface  of  the  tuberosity  of  the  ischium, — into  the  rough 
line  leading  from  the  great  trochanter  to  the  linea  aspera,  the  whole  length 
of  the  linea  aspera,  and  by  a  tendon  into  the  tubercle  above  the  inner  con- 


FlG.  48. 


dyle  of  the  femur.  Action,  to  adduct  the  thigh 
and  rotate  it  outwards.  Nerves,  obturator  and 
great  sciatic.  This  muscle  is  pierced  by  4  aper- 
tures for  the  3  superior  perforating  and  the  profunda 
arteries,  and  about  the  lower  one-third  of  its 
insertion  an  angular  interval  is  left  therein,  the 
lower  opening  of  Hunter's  canal,  for  the  passage 
of  the  femoral  vessels  into  the  popliteal  space. 

Gluteus   Maximus,^  from  the  superior  curved   line 

of  the  ilium,  the  crest  behind  it,  the  last  piece  of 

the  sacrum,  the  side  of  the  coccyx  and  the  great 

and    posterior    sacro-sciatic    ligaments, — into    the 

fascia   lata   and   the  rough   line  leading  from  the 

great   trochanter   to   the  linea  aspera.     Action,  to 

extend  and  abduct  the  thigh  and  rotate  it  out- 
wards, also  to  maintain  the  trunk  erect.     Nerves, 

inferior    gluteal    and    a  branch  from    the   sacral 

plexus. 
Gluteus  Medius,^  from  the  ilium   between  the  su- 
perior and  middle  curved  lines,  the  crest  between 

them  and  the   fascia  of  the  part, — into  the  oblique 

lines  on  the  great  trochanter.     Action,  its  posterior 

fibres  rotate  the  thigh  outwards,  its  anterior  fibres 

rotate  inwards.      It   also   abducts  the  thigh    and 

draws  it  forwards,  and  assists  to  maintain  the  trunk 

erect.     Nerve,  superior  gluteal. 
Gluteus  Minimus,^  from  the  ilium  between  the  middle  and  inferior  curved 

lines,  and  the  margin  of  the  great  sacro-sciatic  notch, — into  the  anteriof 


94 


ANATOMY. 


border  of  the  great  trochanter.     Action,  to  rotate  the  thigh  inwards,  also 
to  abduct  and  draw   it   forwards,  and  to  maintain  the  trunk  erect.     Nerve, 
superior  gluteal. 
Pyriformis,^  by  3  digitations  from  the  front  of  the  sacrum,  from  the  margin 
of  the  great  sacro-sciatic  foramen  and  the  great  sacro-sciatic  ligament, — into 
the  upper  border  of  the  great  trochanter,'  having  passed  through  the  great 
sacro-sciatic  foramen.     Action,  an  external  rotator  of  the  thigh.     iVerves, 
branches  from  the  sacral  plexus. 
Obturator   Intemus,^^  from    the   posterior    bony   margin   of  the   obturator 
foramen  and  the  inner  surface  of  the  obturator  membrane, — into  the  great  tro- 
chanter,' passing  through  the  lesser  sacro-sciatic  notch.     Action,  an  external 
rotator  of  the  thigh.     Nerves,  branches  from  the  sacral  plexus. 
Gemellus  Superior,^®  from  the  outer  surface  of  the  spine  of  the  ischium, — 
into  the  great  trochanter,  being  blended  with  the  tendon  of  the  obturator 
intemus.     Action,  an  external  rotator  of  the  thigh.     Nerves,  branches  from 
the  sacral  plexus. 
Gemellus   Inferior,!^  from   the   tuberosity  of  the  ischium, — into  the  tendon 
of    the   obturator  internus  and  the    great  trochanter.     Action,  an  external 
rotator  of  the  thigh.     Nerves,  branches  from  the  sacral  plexus. 

Obturator  Extemus,  from  the  anterior 
inner  bony  margin  of  the  obturator  fora- 
men, and  the  inner  two-thirds  of  the 
anterior  surface  of  the  obturator  mem- 
brane,— into  the  digital  fossa  of  the 
femur  at  the  inner  base  of  the  great 
trochanter.  Action,  an  external  rotator 
of  the  thigh.  Nerve,  obturator. 
Quadratus  Femoris,^'  from  the  tuberosity 
of  the  ischium, — into  the  upper  part  of 
the  linea  quadrati  on  the  trochanter 
major  posteriorly.  Action,  an  external 
rotator  of  the  thigh.  Nerves,  branches 
from  the  sacral  plexus. 
Biceps,'^  by  2  heads,  the  Long  Headd  from 
the  tuberosity  of  the  ischium  posteri- 
orly, the  Short  Head,e  from  the  outer 
lip  of  the  linea  aspera,  and  the  inter- 
muscular septum, — into  the  outer  side 
of  the  head  of  the  fibula;  its  tendon  embracing  the  external  lateral  ligament 
of  the  kne^  joint,  and  forming  the  Outer  Hamstring,  the  tendons  of  the  semi- 


MUSCLES  OF  THE  LEG.  95 

tendinosus,  semi-membranosus,  gracilis,  and  sartorius,  forming  the  Innei 
Hamstring.  Action,  to  flex  the  leg  and  rotate  it  outwards.  Nerve,  great 
sciatic. 

Semi-tendinosus.y/rcw  the  tuberosity  of  the  ischium  by  a  tendon*  common 
to  it  and  the  long  head  of  the  biceps,  and  from  the  adjacent  aponeurosis, — 
into  the  shaft  of  the  tibia  at  its  upper  and  inner  surface,  its  tendon  curving 
around  the  inner  tuberosity.  Action,  to  flex  the  leg  upon  the  thigh.  Nerue, 
great  sciatic. 

Semi-membranosus,^  from  the  tuberosity  of  the  ischium  above  the  origin  ol 
the  above-named  muscles, — into  the  inner  tuberosity  of  the  tibia;  its  tendon 
dividing  into  3  parts,  one  over  the  popliteus  muscle,  and  another  forming 
the  posterior  ligament  of  the  knee-joint.  Action,  to  flex  the  leg,  and  rotate 
it  inwards.     Nerve,  great  sciatic. 

External  Rotators  of  the  Hip-joint  are  13^,— the  3  adductors,  pyriformis,  « 
obturators,  2  gemelli,  quadratus  femoris,  pectineus,  psoas  magnus,  iliacus,  sar- 
torius, and  posterior  half  of  the  gluteus  medius. 

Internal  Rotators  of  the  Hip-joint  are  2%,, — the  tensor  vaginae  femoris,  gluteus 
minimus,  and  the  anterior  half  of  the  gluteus  medius. 

MUSCLES   OF   THE  LEG. 
Muscles  of  the  leg  arranged  in  groups  of  threes.     (Pancoast.) 
Tibialus  Anticus.  Tibialus  Posticus. 

Extensor  Proprius  Pollicis.  Flexor  Longus  Pollicis. 

Extensor  Longus  Digitorum.  Flexor  Longus  Digitorum. 

Gastrocnemius.  Peroneus  Longus. 

Soleus.  Peroneus  Brevis. 

Plantaris.  Popliteus.  Peroneus  Tertius. 

Tibialis  Anti'cus^  (Flexor  Tarsi  Tibialis), /?-ow  the  outer  tuberosity  and  upper 
two-thirds  of  the  shaft  of  the  tibia  externally,  the  interosseous  membrane, 
deep   fascia,  and   intermuscular   septum, — through  the  inner    canal  in  the 
,  anterior  annular  ligament  into  the  inner  and  plantar  surface  of  the  internal 
cuneiform  bone,  and  the  base  of  the  ist  metatarsal.    Action,  to  flex  the  tarsus 
on  the  leg,  and  elevate  the  inner  border  of  the  foot.     Nerve,  anterior  tibiah 
Extensor  Proprius  Pollicis,^  from  the  middle  two-fourths  of  the  fibula  ante- 
riorly and  the  interosseous  membrane, — through  the  2d  canal  in  the  anterioi 
annular  ligament, — into  the  base  of  the  last  phalanx  of  the  great  toe.    Action, 
to  extend  that  toe.     Nerve,  anterior  tibial. 
Erxtensor  Longus  Digitorum,* /rc>;«  the  outer  tuberosity  of  the  tibia,  the  upper 
three-fourths  of  the  shaft  of  the  fibula  anteriorly,  interosseous  membrane, 
deep  fascia,  and  intermuscular  septa, — into  the  2d  and  3d  phalanges  of  AV «» 


96 


ANATOMY. 


4  lesser  toes,  by  4  tendons  which  pass  over  the  dorsum  of  the  foot,  from  the 
outer  canal  in  the  anterior  annular  ligament.  Ac- 
Hon,  to  extend  the  lesser  toes.    N^erve^  anterior  tibial 


Fig.  so. 


Peroneus  Tertius^  (Flexor  Tarsi  Fibularis),/r^//z  the. 
outer  lower  one-fourth  of  the  fibula,  interosseous 
membrane,  and  intermuscular  septum, — into  the 
base  of  the  5th  metatarsal  bone.  This  muscle  is 
a  part  of  the  last  named,  and  passes  through  the 
same  canal  in  the  annular  ligament.  Action,  to 
flex  the  tarsus.     Nerve,  anterior  tibial. 

Gastrocnemius,  by  2  heads  from  the  condyles  of 
the  femur,  and  the  supra-condyloid  ridges, — unites 
with  the  tendon  of  the  soleus  to  form  the  tendo 
Achillis,  into  the  posterior  tuberosity  of  the  os  calcis. 
Action,  to  extend  the  foot.    Nerve,  internal  popliteal. 

Soleus,  from  the  head  and  upper  one-half  of  the 
shaft  of  the  fibula  posteriorly,  the  oblique  line  of 
the  tibia,  and  the  tendinous  arch, — unites  with  the 
tendon  of  the  gastrocnemius  as  the  tendo  Achillis 
(see  above).  Action,  to  extend  the  foot.  Nerve, 
internal  popliteal. 

Plantaris,  from  the  outer  bifurcation  of  tlie  linea 
aspera,  and  posterior  ligament  of  the  knee-joint, 
by  a  very  long,  delicate  tendon, — into  the  posterior 
surface  of  the  os  calcis.  Action,  to  extend  the  foot. 
Nerve,  internal  popliteal. 
Popliteus,^y>'^/«  a  depression  on  the  external  condyle 
of  the  femur,  and  the  posterior  ligament  of  the  knee- 
joint, — into  the  inner  two-thirds  of  the  triangular  surface  on  the  shaft  of 
the  tibia  posteriorly  and  above  the  oblique  line.  Action,  to  flex  the  leg- 
Nerve,  internal  popliteal. 

Flexor  Longus  Pollicis,^  from  the  lower  two-thirds  of  the  shaft  of  the  fibula 
internally,  the  interosseous  membrane,  fascia,  and  intermuscular  septum, — 
through  grooves  in  the  tibia,  astragalus,  and  os  calcis, — into  the  base  of  the 
last  phalanx  of  the  great  toe.  Action,  to  flex  the  great  toe.  Nerve,  poste- 
rior tibial. 

Flexor  Longus  Digitorum,^  from  the  shaft  of  the  tibia  posteriorly  and 
below  the  oblique  line,  and  the  intermuscular  septum, — passes  behind  the 
inner  malleolus  in  a  groove^^  with  the  tibialis  posticus, — into  the  bases  of 


FASCIA  OF  THE  FOOT. 


91 


the  last  phalanges  of  the  lesser  toes  by  4  tendons  which 
perforate  the  tendons  of  the  flexor  brevis  digitorum. 
Action,  to  flex  the  phalanges  and  extend  the  foot.  Nerve, 
posterior  tibial. 

Tibialis  Posti^cus,^  by  two  processes  between  which  pass  the 
anterior  tibial  vessels,  frofn  the  upper  one-half  of  shaft  of 
the  tibia  posteriorly,  the  upper  two-thirds  of  the  shaft  of  the 
fibula  internally,  the  interosseous  membrane,  deep  fascia, 
and  intermuscular  septa, — passes  behind  the  inner  malle- 
olus in  a  groove  ^^  with  the  long  flexor,  inio  the  tuberosity 
of  the  scaphoid  and  internal  cuneiform  bones.  Action,  to 
extend  the  tarsus,  and  invert  the  foot.  Nerve,  posterior 
tibial. 

Peroneus  Longus,^"  from  the  head  of  the  fibula  and  the 
upper  two-thirds  of  its  shaft  externally,  the  deep  fascia, 
and  intermuscular  septa, — passes  behind  the  outer  malleo- 
lus in  a  groove  with  the  peroneus  brevis,  through  a  groove 
in  the  cuboid  bone,  to  the  outer  side  of  the  base  of  the 
1st  metatarsal  bone.  Action,  to  extend  and  evert  the  foot. 
Nerve,  musculo-cutaneous. 

Peroneus  Brevis,^i  from  the  middle  one-third  of  the  shaft 
of  the  fibula  externally,  and  the  intermuscular  septa, — 
passes  behind  the  external  malleolus  in  a  groove  with 
the  long  peroneal,  into  the  dorsum  of  the  base  of  the  5th 
metatarsal  bone.  Action,  to  extend  the  foot.  Nerve^ 
musculo-cutaneous  branch  of  extei-nal  popliteal. 


Fig.  51. 


FASCIA.  OF  THE   FOOT. 

Anterior  Annular  Ligament,  consists  of  vertical  and  horizontal  portions, 
is  attached  to  the  lower  ends  of  the  fibula  and  tibia,  the  os  calcis  and  the 
plantar  fascia.  It  contains  5  sheaths  lined  by  synovial  membranes  for  the 
tendons  of  the  extensor  muscles,  that  of  the  extensor  proprius  pollicis  pass- 
ing beneath  it,  as  also  the  anterior  tibial  vessels  and  nerve. 

Internal  Annular  Ligament,  from  the  inner  malleolus  to  the  os  calcis, 
converting  3  bony  grooves  into  canals  lined  by  synovial  membranes  for  the 
flexor  tendons  and  the  posterior  tibial  vessels  and  nerve. 

External  Annular  Ligament,  from  the  outer  malleolus  to  the  os  calcis, 
binding  down  the  peronei  tendons  in  one  synovial  sac. 

Plantar  Fascia,  the  densest  in  the  body,  divided  into  a  central  and  two 
lateral  portions,  and  attached  to  the  inner  tuberosity  of  the  os  calcis,  divides 
into  5  processes,  i  for  each  toe,  and  several  intermuscular  septa. 
9  G 


98 


ANATOMY. 


MUSCLES  OF  THE  FOOT. 
Extensor   Brevis  Digitorum,  the  only  muscle  on   the  dorsum  of  the  foot, 
arises  yr^z?/  the  os  calcis  externally,  the  astragalo-calcanean  and  the  anterior 
annular  ligaments, — by  4  tendons,  I  into  the   ist  phalanx  of  the  great  toe, 
and  the  others  into  the  outer  sides  of  the  long  extensor  tendons  of  the  2d, 
3d,  and  4th  toes.     Action,  to  extend  the  toes.     Nerve,  anterior  tibial. 
Muscles  on  the  sole  of  the  foot  (19),  by  layers: — 
1st  Layer.  3d  Layer. 

Flexor  Brevis  Digitorum.     Flexor  Brevis  Pollicis. 

Flexor  Brevis  Minimi  Digiti.    -i  Pancoast's  Tri, 
Adductor  Pollicis.  \  angle,  the  low- 

Transversus  Pedis.  J  est  in  the  body. 

4th  Layer. 
Inter ossei  [4  Dorsal,^  Plantar). 
Abductor  Pollicis,<»  from  the  inner  tuberosity  of  the  os  calcis,  the  internal 
annular  ligament,  plantar  fascia,  and  intermuscular  septum, — into  the  inner 
side  of  the  base  of  the  ist  phalanx  of  the  great  toe.     Action,  to  abduct  the 
great  toe.     Nerve,  internal  plantar. 
Flexor  Brevis  Digitorum,/  from  the  inner  tuberosity  of  the  os  calcis,  the 
plantar   fascia   and   intermuscular   septa, — into   the   sides   of   the  2d   pha- 


Abductor  Pollicis. 
Abductor  Minimi  Digiti. 

2d  Layer. 
Flexor  Accessorius. 
Lumbricales  {4). 


Fig.  52. 


langes  of  the  lesser  toes  by  4  tendons  which 
are  perforated  for  the  long  flexor  tendons. 
Action,  to  flex  the  lesser  toes.  Nej-ve,  internal 
plantar. 

Abductor  Minimi  Digiti,^^  from  the  outer  tuber- 
osity and  under  surface  of  the  os  calcis,  the 
plantar  fascia  and  the  intermuscular  septum, — 
into  the  base  of  the  1st  phalanx  of  the  little  toe 
with  the  tendon  of  its  short  flexor.  Action,  to 
abduct  the  little  toe.     Nerve,  external  plantar. 

Flexor  Accessorius,  by  2  heads,  froj)i  the  os 
calcis  and  the  calcaneo-scaphoid  and  long 
plantar  ligaments, — into  the  tendon  of  the  flexor 
longus  digitoi-um.  Action,  accessory  flexor  of 
the  toes.     Nerve,  external  plantar. 

Lumbricales^  [/\),from  the  long  flexor  tendons 
— into  the  inner  side  of  the  second  phalanges 
of  the  lesser  toes.  Action,  accessory  flexors. 
Nerves,  internal  plantar  to  the  two  internal, 
external  plantar  to  the  others. 


THE  HEART.  9$ 

Flexor  Brevis  Pollicis,'^  frotn  the  cuboid  and  external  cuneiform  bones,  and  the 
prolonged  tendon  of  the  tibialis  posticus, — into  both  sides  of  the  base  of  the 
1st  phalanx  of  the  great  toe,  by  2  portions,  of  which  one  blends  with  the 
abductor  pollicis,  the  other  with  the  adductor  pollicis.  Action,  to  flex  the 
great  toe.     Nerve,  internal  plantar. 

Adductor  Pollicis, /r^w  the  tarsal  ends  of  the  three  middle  metatarsal  bones, 
and  the  sheath  of  the  tendon  of  the  peroneus  longus,— m/(?  the  base  of  the 
1st  phalanx  of  the  great  toe,  externally.  Action,  to  adduct  the  great  toe. 
Nerve,  external  plantar. 

Flexor  Brevis  Minimi  Digiti,^'  from  the  base  of  the  5th  metatarsal  bone  and 
the  sheath  of  the  tendon  of  the  peroneus  longus, — into  the  base  of  the  ist 
phalanx  of  the  little  toe  externally.  Action,  to  flex  the  little  toe.  Nerve, 
external  plantar. 

Transversus  Pedis,  from  the  under  surface  of  the  head  of  the  5th  metatarsal 
bone,  and  the  transverse  ligament  of  the  metatarsus, — into  the  outer  side  of 
the  1st  phalanx  of  the  great  toe,  blending  with  the  tendon  of  the  adductor 
pollicis.     Action,  to  adduct  the  great  toe.     Nerve,  external  plantar. 

Dorsal  Interossei  (4),  each  by  two  heads /r^w  the  adjacent  sides  of  two  meta- 
tarsal bones, — into  the  base  of  the  1st  phalanx  of  the  corresponding  toe. 
Action,  to  abduct  the  toes.     Nerve,  external  plantar. 

Plantar  Interossei/  (3),  from  the  shafts  of  the  3d,  4th,  and  5th  metatarsal 
bones, — i^ito  the  bases  of  the  ist  phalanges  of  the  same  toes.  Action,  to 
adduct  the  toes  towards  the  median  line.     Nerve,  external  plantar. 

THE   HEART. 

What  is  the  Pericardium  "i  It  is  a  conical  membranous  closed  sac,  con- 
taining the  heart  and  the  roots  of  the  great  vessels.  It  lies  behind  the  sternum 
and  between  the  pleurae,  its  apex  upwards,  its  base  below  and  attached  to  the 
central  tendon  of  the  diaphragm.  It  is  composed  of  an  outer  fibrous  coat, 
and  an  inner  serous  one ;  the  latter  consisting  of  two  portions,  a  parietal  layer, 
lining  the  inner  surface  of  the  fibrous  coat,  and  a  visceral  layer,  which  is  re- 
flected over  the  heart  and  vessels.  The  serous  portion  secretes  a  thin  fluid, 
about  I  drachm  in  quantity  normally,  for  the  lubrication  of  its  surfaces.  The 
fibrous  coat  is  prolonged  on  the  outer  surfaces  of  the  great  vessels,  except  the 
inferior  vena  cava,  and  becomes  continuous  with  the  deep  layer  of  the  cervical 
fascia. 

Describe  the  Endocardium.  It  is  a  serous  membrane  which  lines  the 
inner  surface  of  the  heart,  forming  by  its  reduplications  the  cardiac,  aortic, 
and  pulmonary  valves,  and  continuous  with  the  lining  membrane  of  the  grea' 
vessels. 


lOO  ANATOMY. 

Describe  the  Heart.  It  is  a  hollow  muscular  organ,  conoidal  in  shape, 
placed  obliquely  in  the  chest  between  the  lungs,  base  upwards,  apex  towards 
the  left  and  front,  corresponding  to  the  interspace  between  the  5th  and  6th 
costal  cartilages,  one  inch  inside  of  and  two  inches  below  the  left  nipple.  In 
the  adult  its  size  is  about  5  inches  by  3^^  by  2^,  and  from  8  to  12  oz.  in 
weight. 

What  are  the  Cavities  of  the  Heart  ?  They  are  4  in  number,  an 
auricle  and  a  ventricle  on  each  side  of  the  heart,  separated  by  a  longitudinal 
muscular  septum,  and  indicated  on  the  external  surface  of  the  organ  by  grooves, 
named,  from  their  contiguous  cavities,  as  the  Auriculo-ventricular  Groove  trans- 
versely, and  the  Inter-  Ventricular  Groove  longitudinally. 

Describe  the  Right  Auricle.  It  is  larger  than  the  left,  can  hold  about  2 
fluidounces,  its  walls  being  about  i  line  in  thickness.  It  receives  the  venous 
blood  by  the  superior  and  inferior  venae  cava;  and  the  coronary  sinus,  and 
presents  interiorly  the  following  points  for  examination: — 

Appendix  Auriculw,  a  conical  pouch  projecting  from  the  auricle  to  the  front 

and  left,  its  margins  being  dentated. 
Openings  of  the  superior  and  inferior  venae  cavse  and  the  coronary  sinus,  the 

latter  having  a  valve  in  two  segments. 
Foramina  Thehesii,  several  minute  orifices,  the  mouths  of  veins  from  the 

substance  of  the  heart. 
Tubercle  of  Lower,  a  very  small  projection  on  the  right  wall,  supposed  to 

influence  the  direction  of  the  blood-current. 
Eustachian  Valve,  at  the  anterior  margin  of  the  inferior  vena  cava;  large  if*- 

the  foetus,  to  direct  the  blood  to  the  foramen  ovale. 
Fossa  Ovalis,  a  depression  on  the  inner  wall,  and  the  situation  of  the  foramen 

ovale  in  the  foetus. 
Annulus  Ovalis,  the  oval  margin  of  the  fossa  ovalis. 
Musculi  PectinaU,  muscular  columns  on  the  inner  surface  of  the  appendix 

and  the  inner  wall  of  the  auricle. 
Auriculo-ventricular  Opening,  communicates  with  the  right  ventricle,  is  oval, 
about  an  inch  broad,  surrounded  by  a  fibrous  ring,  and  is  guarded  by  the 
tricuspid  valve. 

Describe  the  Right  Ventricle.  Its  form  is  conical,  its  cavity  containing 
about  2  fluidounces,  its  apex  above  the  apex  of  the  heart,  and  it  presents  in- 
teriorly the  following,  viz. — 

Tricuspid  Valve,  consists  of  3  triangular  segments  connected  by  their  base* 
with  the  auriculo-ventricular  orifice,  and  by  their  sides  with  each  other, 
the  largest  being  on  the  left  side. 
Chordce  Tendince,  delicate  tendinous  cords  which  connect  the  margins  and 
lower  surfaces  of  the  tricuspid  valve  with  the  columnse. 


THE  HEART, 


101 


ColumtuB  Carnea,  muscular  columns  projecting  from  the  surface  of  the  ven- 
tricle, of  which  3  or  4,  called  Columnce  Papillares,  give  attachment  to  the 
chordae  tendinae. 
Semilunar  Valves,  are  3  in  number,  and  guard  the  orifice  of  the  pulmonary 
artery,  each  about  the  middle  of  its  free  margin  has  a  fibro-cartilaginous 
nodule,  the  Corpus  Arantii,  which  more  perfectly  closes  the  orifice. 
Opening  of  the  Pulmonary  Artery,  at  the  superior  and  internal  angle  of  the 
ventricle,  the  Conus  Arteriosus.     It  is  circular  in  form,  surrounded  by  a 
fibrous  ring,  and  is  guarded  by  the  semilunar  valves. 
Sinuses  of  Valsalva,  are  3  pouches,  one  behind  each  valve,  between  it  and 

the  commencement  of  the  pulmonary  artery. 
Describe  the  Left  Auricle.      Its  walls  are  about  i}4.   lines  in  thickness, 
its  capacity  rather  less  than  2  fluidounces,  has  an  appendix  auriculae,  and 
receives  the  arterialized  blood  from  the  lungs.     It  presents  the  following  in- 
ternally : — 

Openings  of  the  Pulmonary  Veins,  are  4  in  number,  sometimes  3,  as  the  two 

left  veins  frequently  end  in  a  common  opening. 
Left  Auriculo-ventricular  Opening,  is  smaller  than  the  right  one. 
Musculi  Pectinati,  on  the  inner  surface  of  the  appendix. 
Depression,  corresponding  to  the  fossa  ovalis  in  the  right  auricle. 
Describe     the     Left    Ventricle. 
It  is  longer,  thicker,  and  more  coni- 
cal than  the  right,  projecting  towards 
the  posterior  aspect.     Its  walls«  are 
the  thickest  of  those  in  the  heart, 
being  twice  as  thick  as  those  of  the 
right  ventricle.    Its  interior  presents 
the  following  : — 

Aortic  Opening,  is  small  and  cir- 
cular, placed  in  front  and  to 
the  right  of  the  auriculo-ven- 
tricular, a  segment  of  the  mitral 
valve  being  between  them.  It 
is  surrounded  by  a  fibrous  ring, 
and  guarded  by  semilunar 
valves. 
Mitral  Valve,c  consists  of  two 
unequal-sized  segments,  and  is 
attached  to  the  fibrous  ring  which  surrounds  the  auriculo-ventricular 
opening.  Its  margins  are  connected  with  the  ventricular  walls  by  Chorda 
Tendin(B<i  and  Musculi  Papillares. 


102  ANATOMY. 

Semilunar  Valves,  guard  the  aortic  orifice,  and  are  larger  and  stronger  thais 

those  on  the  right  side. 
Sinus  Aorlici,  or  sinus  of  Valsalva,  a  pouch  between  each  valve   and  the 

beginning  of  the  aorta. 
Columna;  Carnece,^  are  smaller  and  more  numerous  than  on  the  right  side ; 

the  Musculi  Papillares  are  but  tw^o  in  number. 
Describe  the  Structure  of-  the  Heart.  The  muscular  fibres  take  origin 
from  the  four  fibrous  rings  at  the  auriculo-ventricular  and  aortic  openings. 
The  fibres  of  the  auricles  are  arranged  in  two  layers,  a  superficial  and  a  deep 
one,  the  latter  having  looped  fibres  and  annular  fibres.  In  the  ventricles  the 
fibres  are  superficial  and  deep,  the  latter  being  arranged  circularly,  the  former 
spirally,  coiling  inwards  at  the  apex  of  the  heart  into  a  whoil-like  form,  the 
vortex. 

THE   ARTERIES. 

What  are  the  Arteries  ?  Cylindrical  vessels  which  carry  arterial  blood  to 
the  body  from  the  heart.  Those  going  to  the  lungs  with  the  returning  veins, 
form  the  Lesser  or  Pulmonic  Circulation.  The  aorta  with  its  branches  and  the 
returning  veins,  constitute  the  Greater  or  Systemic  Circulation.  The  arteries 
anastomose  or  communicate  freely  with  each  other  everywhere  throughout  the 
body,  permitting  the  establishment  of  collateral  circulations. 

Describe  the  Structure  of  the  Arteries.  They  are  dense,  very  elastic, 
preserving  their  cylindrical  form,  and  are  composed  of  3  coats,  an  Internal  or 
serous  ;  a  Middle^  which  is  of  muscular  and  elastic  tissue ;  and  an  External, 
of  connective  tissue.  They  are  generally  included  in  a  fibro-areolar  invest- 
ment, the  Sheath,  which  also  encloses  the  accompanying  veins.  The  larger 
arteries  are  nourished  by  the  Vasa  Vasorum,  blood-vessels  which  ramify  in  the 
external  and  middle  coats;  and  are  supplied  with  nerves,  the  Vaso-motor, 
derived  from  both  the  sympathetic  and  cerebi-o-spinal  systems,  and  forming 
intricate  plexuses  on  the  larger  trunks. 

What  are  the  Capillaries  ?  Minute  vessels  forming  a  network  throughout 
the  tissues  of  the  body  between  the  terminating  arteries  and  the  commencing 
veins.  Their  average  diameter  is  about  the  ^oVir  °^  ^"  inch,  and  their  walls 
consist  of  a  transparent  homogeneous  membrane  continuous  with  the  innermost 
layer  of  the  arterial  and  venous  walls. 

[In  the  following  pages,  main  branches  are  in  italics,  sub-branches  in  Roman.] 

Describe  the  Aorta.  It  is  the  main  trunk  of  the  systemic  arteries,  com- 
mencing at  the  aortic  opening  of  the  left  ventricle  of  the  heart,  arching  back- 
wards, over  the  roof  of  the  left  lung  into  the  thorax,  where  it  descends  on  the 
left  of  the  spinal  column,  and  after  passing  through  the  aortic  opening  in  the 
diaphragm,  it  terminates  in  the  right  and  left  common  iliac  arteries  oppositt 


THE   ARTERIES. 


103 


the  4th  lumbar  vertebra.  It  is  divided  into  the  arch,  the  thoracic  aorta,  and  the 
abdominal  aorta ;  and  the  arch  is  subdivided  into  the  ascending,^  transverse,^  and 
descending  ^^  portions.  The  upper  border  of  the  arch  is  generally  situated  about 
an  inch  below  the  upper  margin  of  the  sternum.  The  branches  of  the  aorta  are,-^ 
From  the  Arch, — 2  Coronary.^         Left  Common  Carotid}^ 

In7iominate!}        Left  Subclavian)^ 
From  the  Thoracic, — Pericardiac.  (Esophageal.         20  Lntercostals. 

Bronchial.  Posterior  Mediastinal. 

From  the  Abdominal, — 2  Phrenic. 


Cceliac  Axis. 


2  Spermatic. 
Lnferior  Mesenteric. 
8  Lumbar. 
Sacra  Media. 
2  Common  Lliac. 


Fig.  54. 


Gastric. 
Hepatic. 
Splenic. 
Superior  Mesenteric. 
2  Supra-renal. 
2  Renal. 

Describe  the  Coronary  Arteries.  They  are  2 
in  number,  a  right  and  a  left,*  arise  from  the  aorta 
behind  the  semilunar  valves  and  run  in  the  ver- 
tical grooves  of  the  heart,  the  left  artery  in  front,  to 
supply  the  tissue  of  that  organ. 

Describe  the  Innominate.''  It  arises  from  the 
summit  of  the  arch  of  the  aorta,  is  i^  inch  long, 
and  divides  behind  the  right  sterno-clavicular  joint 
into  the  Right  Common  Carotid^  and  Right  Subcla- 
vian? these  arteries  on  the  left  side  of  the  body  aris- 
ing directly  from  the  arch  of  the  aorta.^^  ^^  It  some- 
times sends  off  a  Middle  Thyroid  (artery  of 
Neubauer)  which  may  arise  directly  from  the 
arch  of  the  aorta.  The  innominate  is  sometimes 
absent,  and  not  infrequently  varies  in  length  from 
an  inch  to  two  or  more. 

Describe  the  Common  Carotid.  Arising  differently  (see  above),  the  two 
carotids  are  similarly  described,  except  that  the  left  is  longer  and  deeper  than 
the  right  one.  Their  course  is  indicated  by  a  line  drawn  from  a  point  midway 
between  the  angle  of  the  lower  jaw  and  the  mastoid  process  to  the  sterno' 
clavicular  articulation.  At  the  lower  part  of  the  neck  they  are  separated  only 
by  the  width  of  the  trachea,  and  they  are  each  contained  in  a  sheath  of  the 
deep  cervical  fascia  with  the  internal  jugular  vein  externally  and  the  pneumo- 
gastric  nerve  between  the  artery  and  vein.  On  the  front  of  the  sheath  lies  the 
descendens  noni  nerve  (descending  branch  of  the  9th  or  hypoglossal).  The 
artery  lies  beneath  the  inner  border  of  the  sterno-cleido-mastoid  muscle,  and  is 
crossed  about  its  middle  by  the  omo-hyoid  muscle  and  the  middle  thyroid  vein. 


104 


ANATOMY. 


It  is  also  crossed  above  by  the  facial,  lingual,  and  superior  thyroid  veins,  below 
by  the  anterior  jugular  vein,  and  on  the  left  side  often  by  the  internal  jugular 
vein.  It  bifurcates,  at  the  level  of  the  upper  border  of  the  thyroid  cartilage, 
into  the  External  and  Internal  Carotids,  of  which  the  internal  is  the  most  re- 
mote from  the  median  line. 

Name  the   Branches  and   Sub-branches  of  the  External  Carotid  Ar^ 
tery.2  (Fig.  55.)     It  has  8  branches,  as  follows,  viz. — 

Superior  Thyroid,^  arising  below  the  greater  cornu  of  the  hyoid  bone. 
Muscular.  Hyoid.  Superior  Laryngeal. 

Glandular.  Superficial  Descending.  Crico-thyroid. 

Lingual^  under  the  hyo-glossus  muscle  to  the  tongue. 
Hyoid.         Dorsalis  Linguae.         Sublingual.         Ranine. 


Fig.  56. 

THE   RIGHT   INTERNAL    MAXILLARY  ARTERY 


Fig.  55 


Facial^  crosses  the  lower  jaw  at  the  anterior  angle  of  the  masseter. 
Inferior  or  Ascending  Palatine.         Submental.^  2  Coronary.^s 

Tonsillar.  Muscular.  Lateralis  Nasi. 

Submaxillary.  Inferior  Labial.       Angular. 


THE  ARTERIES.  105 

Occipital}^  lies  in  the  occipital  groove  of  the  temporal  bone. 
Muscular,  Inferior  Meningeal.  Cranial  Branches,  over 

Auricular.  Arteria  Princeps  Cervicis.^'  the  occiput. 

Posterior  Auricular}^  ascends  under  cover  of  the  parotid  gland. 

Stylo-mastoid.  Auricular.  Muscular.  Glandular. 

Ascending  Pharyngeal,  lies  on  the  rectus  capitis  anticus  major. 

External  Branches.  Pharyngeal  and  Meningeal  Branches. 

Temporal}^  the  smallest  of  the  termini  of  the  external  carotid,  begins  in 
the  parotid  gland,  crosses  the  zygomatic  arch,  and  divides  into  anterior  ^' 
and  posterior  temporal.^* 

Transverse  Facial.^^       Middle  Temporal. ^'^       Anterior  Auricular. 
Internal  Maxillary,^  the  other  terminal   branch  of  the   external  carotid,^ 
is  divided  into  three  portions,  Maxillary,*  Pterygoid,^  and  Spheno-maxil- 
lary,^  which  respectively  give  off  the  following  branches:   (Fig.  56.) 
Deep  Auricular,  to  the        Deep  Temporal,  Alveolar.^^ 

tragus  and  canal.  ant.  and  posterior.    Infra-orbital.^^ 

Tympanic,''  entering  Pterygoid  Branches,    Descending  Palatine,^' 

the  Glaserian  fissure.  to  those  muscles.      Vidian.^^ 

Middle  Meningeal.^  Masseteric,  to  the         Pterygo-palatine.*^ 

Small  Meningeal.^  masseter  muscle,      Spheno-palatine  or  Nasal.** 

Inferior  Dental,^®  divides    Buccal,  to  the  bucci- 

into  Incisor  and  Mental.  nator  muscle. 
Describe  the  Internal  Carotid  Artery.  It  ascends  in  front  of  the  transverse 
processes  of  the  three  upper  cervical  vertebrae,  and  close  to  the  tonsil,  traverses 
the  carotid  canal  in  the  temporal  bone,  and  after  piercing  the  dura  mater  by  the 
anterior  clinoid  process,  divides  into  its  terminal  branches.  Its  branches  are 
the 

Tympanic,  enters  the  tympanum  from  the  carotid  canal,  and  anastomoses 
on  the  membrana  tympani  with  the  tympanic  branch  of  the  internal  max- 
illary, the  stylo-mastoid,  and  the  Vidian  arteries. 
Arteria  Receptaculi,  numerous  small  vessels  going  to  the  walls  of  the  sinuses, 
the  Gasserian  ganglion  and  the  pituitary  body ;  one  of  them,  to  the  dura 
mater,  is  called  the  Anterior  Meningeal. 
Ophthalmic,  arises  from  the  cavernous  portion,  enters  the  orbit  through  the 
optic  foramen,  terminating  at  the  inner  angle  of  the  eye  into  the  frontal 
and  nasal  branches.     It  gives  off, — 

Lachiymal.  Short  Ciliary,  Anterior  Ethmoidal. 

Arteria  Centralis  Retinae,    Anterior  Ciliary,  Palpebral. 

Muscular  Branches.  Supraorbital.  Nasal. 

Long  Ciliary.  Posterior  Ethmoidal.        Frontal. 

Anterior  Cerebral,  joined  to  its  fellow  by  the  anterior  communicating  branch, 
about  2  lines  long. 


i06 


ANATOMY. 


Fig.  57. 


Middle  Cerebral^  in  the  fissure  of  Sylvius ;  divides  into  3  branches,  anterior, 

median,  and  posterior. 
Anterior  Choroid^io  the  choroid  plexus,  corpus  fimbriatum,  etc. 
Posterior  Communicating,  anastomoses  with  the  posterior  cerebral,  a  branch 

of  the  basilar. 

What  is  the  Circle  of  Willis  ?  An  anastomosis  at  the  base  of  the  brain, 
between  the  branches  of  the  internal  carotid  and  vertebral  arteries,  to  equalize 
the  cerebral  circulation.  The  2  Vertebral  arteries  join  to  form  the  Basilar, 
which  ends  in  2  Posterior  Cerebral.  These  are  connected  with  the  Internal 
Carotid  by  the  2  Posterior  Communicating.  The  circle  is  completed  by  the 
connection  of  the  2  Anterior  Cerebral  branches  of  the  internal  carotid  through 
the  short  Anterior  Communicating  artery. 

Describe  the  Subclavian.     It  arises  on  the  right  side  from  the  innominate, 

on  the  left  side  from  the  arch  of  the  aorta, 
and  is  divided  into  3  portions  by  the 
scalenus  anticus,  which  crosses  it  just  ex- 
ternal to  the  origin  of  the  thyroid  axis, 
viz. — the  parts  internal,  behind,  and  ex- 
ternal to  that  muscle.  At  the  outer  border 
of  the  1st  rib,  the  subclavian  becomes  the 
axillary  artery.  Its  upper  border  is  a  little 
above  the  clavicle,  and  it  is  separated  from 
the  subclavian  vein  by  the  scalenus  anticus 
at  its  origin  from  the  first  rib.  Its  branches 
are  all  given  off  from  its  first  portion,  ex- 
cept the  Superior  Intercostal,  which  on 
the  right  side  arises  from  the  second  por- 
tion. 

Vertebral,^  passing  up  the  neck,  through 
the   foramina   in   the  transverse   pro- 
cesses of  six    cervical   vertebrae,  and   enters  the   skull   by  the   foramen 
magnum,  where   it  joins   its   fellow   to   form    the  Basilar  Artery.      Its 
branches  are — 

Lateral  Spinal  Branches.  Anterior  Spinal. 

Muscular  Branches.  Posterior  Spinal. 

Posterior  Meningeal.  Inferior  Cerebellar. 

The  Basilar,  formed  by  the  junction  of  the  vertebrals,  gives  off  on  each 
side  a  transverse,  anterior,  and  superior  cerebellar,  and  ends  in  the  two 
posterior  cerebral.     (See  Circle  of  Willis^  above.) 


THE   ARTERIES.  107 

Thyroid  Axis,^  at  once  divides  into  the  three  following  branches: — 
Inferior  Thyroid^  to  the  thyroid  gland,  giving  off, — 

Laryngeal  Branch.  Oesophageal  Branches. 

Tracheal  Branches.  Ascending  Cervical.^ 

Transversalis  Colli}'^  divides  beneath  the  margin  of  the  trapezius  into — 

Superficial  Cervical.  Posterior  Scapular. 

Suprascapular^"^  to  the  shoulder-joint  and  the  dorsum  of  the  scapula,  anas- 
tomosing there  with  the  posterior-  and  sub-scapular. 
Internal  Mammary}^  arises  opposite  the  thyroid  axis,  descends  upon  the 
costal  cartilages,  and  ends  at  the  6th  interval,  in  the  musculo-phrenic  and 
superior  epigastric,  the  latter  anastomosing  with  the  deep  epigastric  branch 
of  the  external  iliac.     Its  branches  are  the — 

Comes  Nervi  Phrenici,         Pericardiac.  Perforating. 

or  Superior  Phrenic.         Sternal.  Musculo-phrenic. 

Mediastinal.  Anterior  Intercostal.       Superior  Epigastric. 

Superior  Intercostal}^  gives  off  branches  in  the  intercostal  spaces  to  th« 
posterior  spinal  muscles  and  to  the  spinal  cord. 

Profunda  Cervicis,*"  supplies  the  muscles  of  the  back  of  the  neck, 
and  anastomoses  with  the  arteria  princeps  cervicis  of  the  occi. 
pital. 

Describe  the  Axillary.*  It  is  the  continuation  of  the  subclavian,  extend- 
ing from  the  edge  of  the  ist  rib  to  the  lower  margin  of  the  armpit  muscles, 
where  it  becomes  the  brachial.     It  has  7  branches,  viz. — 

Superior  Thoracic,  to  the  pectoral  muscles  and  walls  of  the  thorax. 
Acromial  Thoracic,  branches  are  thoracic,  acromial,  descending. 
Thoracica  Longa,  to  the  muscles  of  the  chest  and  mammary  gland. 
Thoracica  Alaris,  a  small  branch  to  the  axillary  glands. 
Subscapular,  to  the  inferior  dorsum  of  the  scapula.    Its  branches  anastomose 
with  the  supra-  and  posterior  scapular,  and  are  the — 

Subscapular.  Dorsalis  Scapulse.  Median  Branch. 

Posterior  Circunijlex,  to  the  deltoid  muscle  and  the  shoulder-joint. 
Anterior  Circumflex,  to  the  joint  and  the  head  of  the  bone,  anastomosing 
with  the  posterior  circumflex  and  acromial  thoracic. 

Describe  the  Brachial.  It  is  the  continuation  of  the  axillary  from  the 
lower  margin  of  the  teres  major  tendon  to  its  bifurcation  into  the  radial  and 
ulnar,  which  is  usually  about  one-half  inch  below  the  bend  of  the  elbow. 
The  median  nerve  crosses  it  from  the  outside  to  the  inside  at  its  centre.  Its 
branches  are  the — 

Superior  Profunda,  winds  over  the  arm  in  the  musculo-spiral  groove,  giving 
off  the  posterior  articular  to  the  elbow  anastomosis. 


108  ANATOMY. 

Nutrient  Branch,  enters  the  nutrient  canal. 

Inferior  Profunda,  to  the  elbow-joint  anastomosis. 

Anastomotica  Magna,  anastomoses  with  the  posterior  articular,  inferior  pro 
funda,  anterior  and  posterior  ulnar  recurrent. 

Muscular  Branches,  to  the  muscles  in  the  course  of  the  artery. 

Describe  the  Radial.  It  extends  from  the  bifurcation  of  the  brachial  to  the 
deep  palmar  arch,  and  gives  off  the  following  branches  respectively,  in  the  fore- 
arm, the  wrist,  and  the  hand,  viz. — 

Radial  Recurrent.  Posterior  Carpal.  Princeps  Pollicis. 

Muscular.  Metacarpal.  Radialis  Indicis. 

Superfcialis   Voice.  Dorsalis  Pollicis.  Perforantes. 

Anterior  Carpal.  Dorsalis  Indicis.  Interossece. 

Name  the  Branches  of  the  Ulnar.  It  extends  from  the  division  of  the 
brachial  to  the  superficial  palmar  arch.     It  has  8  branches,  viz. — 

Anterior  Ulnar  Recurrent.  Muscular.  Deep  or  Communicating 

Posterior  Ulnar  Recurrent.  Anterior  Carpal.       Branch. 

Interosseous  \  .   *  Posterior  Carpal.  Digital. 

(  Posterior. 

Describe  the  Palmar  Arches.  The  Superficial  Palmar  Arch  is  that  part 
of  the  ulna  artery  lying  in  the  palm  of  the  hand,  and  anastomosing  with 
the  superficialis  volae  from  the  radial,  and  a  branch  from  the  radialis  indicis,  at 
the  root  of  the  thumb.  It  gives  off  4  branches,  the  digital,  to  the  sides  of  the 
fingers,  except  the  inside  of  the  index  finger,  which  is  supplied  by  the  radialis 
indicis.  The  Deep  Palmar  Arch  is  formed  by  the  palmar  portion  of  the  radial 
artery  anastomosing  with  the  deep  or  communicating  branch  of  the  ulna.  It 
gives  off  the  radialis  indicis,  palmar  interosseae,  perforating  and  recurrent 
branches. 

Describe  the  Thoracic  Aorta.  It  begins  on  the  left  of  the  spine,  at  the 
lower  border  of  the  3d  dorsal  vertebra,  and  ends  at  the  aortic  opening  in  the 
diaphragm  directly  in  front  of  the  last  dorsal  vertebra.  Its  branches  are  as 
follows  : — 

Pericardiac  Branches,  irregular  in  number  and  origin. 

Bronchial,  also  vary  in  number  and  origin ;  generally  one  on  the  right  side 
and  two  on  the  left.     They  nourish  the  lungs. 

CEsophageal,  4  or  5,  anastomose  on  the  oesophagus  with  branches  of  the  in- 
ferior thyroid,  phrenic,  and  gastric. 

Posterior  Mediastinal,  numerous  small  vessels. 

Intercostals,  usually  ID  on  each  side,  each  dividing  into  an  anterior  and  a 
posterior  branch.  The  anterior  divides  again  into  two  along  the  adjacent 
borders  of  the  ribs,  supplying  the  intercostal  muscles  and  anastomosing  with 


THE   ARTERIES. 


109 


The  posterior  divides 


Fig.  58. 


branches  of  the  internal  mammary  and  axillary 

into  a  spinal  branch  going  to 

the  vertebras  and  the  spinal 

cord,  and  a  muscular  to  the  ^""^^^^^f 

muscles  of  the  back. 

Describe       the      Abdominal 
Aorta.       It    begins    where    the 
thoracic  ends,  and  terminates  at 
the  4th  lumbar  vertebra  in  the 
common  iliacs.     Its  branches  are 
as  follows : — 
CcELiAC   Axis,*  arises    oppo- 
site the  margin  of  the  dia- 
phragm, runs    forwards   for 
half    an    inch   and   divides 
into    the    Gastric,   Hepatic, 
and    Splenic  arteries,  occa- 
sionally giving   off   one  of 
the  phrenics. 
Gastric^  supplies  the  stomach 
along    its    lesser   curvature, 
anastomosing  with  the  aortic, 
oesophageal,  splenic,  and  he- 
patic branches. 
Hepatic,^  divides  in  the  trans- 
verse fissure  of  the  liver  into 
the  right  and  left  branches, 
to  the  lobes  of  that  organ ; 
also  the — 

Pyloric.  Gastro-duodenalis  /  Gastro-epiploica  Dextra 

Cystic.  I  Pancreatico-duodenalis. 

Splenic;'  the  largest  branch  of  the  coeliac  axis,  passes  by  a  very  tortuous 
course  to  the  spleen,  giving  off  the  following : — 
Pancreaticae  Parvge.  Gastric  (vasa  brevia). 

Pancreatica  Magna.  Gastro-epiploica  Sinistra. 

Phrenic}  one  on  each  side,  but  usually  only  one  arises  from  the  aorta,  the 
other  springing  from  either  the  coeliac  axis  or  the  renal  artery.     They  go 
to  the  under  surface  of  the  diaphragm. 
Superior  Mesenteric^  supplies  the  small  intestine,  caecum,  ascending  and 
10 


110  ANATOMY. 

transverse  colon.     Arising  about  one-fourth  inch  below  the  cceliac  axis, 

it  arches  forwards,  downwards,  and  to  the  left,  giving  off — 
Inferior  Pancreatico-duodenal.  Ileo-colic. 

Vasa  Intestini  Tenuis.  Colica  Dextra  and  Media. 

Inferior  Mesenteric^'^  supplies  the  descending  colon,  sigmoid  flexure,  and 

most  of  the  rectum,  giving  off  the  following  branches : — 

Colica  Sinistra.  Sigmoid.  Superior  Hemorrhoidal. 

Supra-renal^  arise  one  on  each  side,  opposite  the  origin  of  the  superior 

mesenteric,  passing  to  the  supra-renal  capsules. 
Renal ^  one  from  each  side,  just  below  the  preceding,  pass  to  the  kidney,  at 

the  hilum  having  the  middle  place  between  the  ureter  behind  and  the 

renal  vein  in  front.     U.  A.  V.  (you  'ave!) 
Spermatic^^  one  on  each  side,  in  the  male  through  the  inguinal  canal  to 

the  testes ;  in  the  female  to  the  ovaries,  uterus,  and  the  skin  of  the  labia 

and  groins. 
Lumbar^  usually  4  on  each  side,  analogous  to  the  intercostals.     They  each 

divide  into  two  branches,  the — 

Dorsal,  giving  off  a  spinal  branch.  Abdominal. 

Middle  Sacral}^  arises  just  at  the  bifurcation  of  the  aorta ;  it  descends  along 

the  sacrum  and  coccyx,  giving  off  numerous  branches. 

Describe  the  Common  Iliac  Arteries.  They  extend  from  the  bifurcation 
of  the  aorta  at  the  4th  lumbar  vertebra  to  near  the  lumbo-sacral  articulation, 
where  they  each  divide  into  the  external '^  and  internal  iliac.^*  They  are 
about  2  inches  in  length,  the  right  being  a  little  longer  than  the  left  one,  and 
each  is  crossed  by  the  ureter,  just  before  its  bifurcation. 

Describe  the  Internal  Iliac.^*  It  is  about  i^  inches  long,  and  extends 
from  the  lumbo-sacral  articulation  to  the  great  sacro-sciatic  notch,  where  it 
divides  into  an  anterior  and  a  posterior  trunk.  From  the  anterior  trunk  are 
given  off  from  above  downwards,  the — 

Superior  Vesical,  the  remaining  pervious  part  of  the  foetal  hypogastric  artery. 
It  sends  branches  to  the  vas  deferens  and  the  ureter ;  and  one,  the  Middle 
Vesical,  to  the  base  of  the  bladder. 
Obturator^  through  the  canal  in  the  obturator  foramen  to  the  thigh,  where  y. 
divides  into  an  internal  and  external  branch.  Within  the  pelvis  it  gives 
off  an  iliac,  vesical,  and  a  pubic  branch.  In  one  out  of  y/z  cases  this 
artery  arises  from  the  epigastric. 
Inferior  Vesical,  to  the  bladder,  prostate  gland,  and  vesiculae  seminales.     In 

the  female  this  artery  is  called  the  Vaginal. 
Middle  Hemorrhoidal,  to  the  rectum. 
Uterine,  in  the  female,  anastomosing  with  the  ovarian. 


THE    ARTERIES,  111 

Internal  Pudic,  the  smaller  of  the  terminal  branches  of  the  anterior  trunk, 
supplies  the  external  generative  organs.     Its  branches  in  the  pelvis  are 
numerous  and  small,  in  the  perineum  they  are — 
Inferior  Hemorrhoidal.  Artery  of  the  Bulb. 

Superficial  Perineal.  Artery  of  the  Corpus  Cavernosum. 

Transverse  Perineal.  Dorsal  Artery  of  the  Penis. 

Sciatic,  the  other  terminal  branch,  supplies  the  muscles  on  the  back  of  the 
pelvis.     Its  branches  are  as  follows : — 

Muscular  Branches.  Coccygeal.  Muscular,  external 

Hemorrhoidal  Branches.    Inferior  Gluteal.  to  the  pelvis. 

Vesical  Branches.  Comes  Nervi  Ischiadic!.    Articular  Branches. 

The  Posterior  Trunk  gives  off  the  following : — 
Ilio-lumbar,  dividing  into  lumbar  and  iliac  branches. 
Lateral  Sacraly  superior  and  inferior  on  each  side. 

Gluteal,  the  continuation  of  the  posterior  trunk,  divides  into  a  superficial  and 
a  deep  branch,  to  the  glutei  muscles,  the  skin  over  the  sacrum,  and  the 
hip-joint.  Before  dividing  it  gives  a  nutrient  branch  to  the  ilium,  and 
some  muscular  branches. 

Describe  the  External  Iliac.  It  extends  to  beneath  the  centre  of  Poupart's 
ligament,  where  it  enters  the  thigh  and  becomes  the  Femoral  Artery,  lying  be- 
tween the  femoral  vein  on  the  inside  and  the  anterior  crural  nerve  on  the  out- 
side— V.A.N.     Its  branches  are,  small  muscular  and  glandular,  and — 

Epigastric,  which  usually  arises  a  few  lines  above  Poupart's  ligament,  passes 
between  the  peritoneum  and  the  transversalis  fascia,  to  the  sheath  of  the 
rectus  which  it  perforates,  and  ascends  behind  that  muscle,  to  anastomose 
by  numerous  branches  with  the  terminal  branches  of  the  internal  mam- 
mary and  inferior  intercostal.     It  gives  off — 

Cremasteric.  Pubic.  Muscular  Branches. 

Circumflex  Iliac,  arises  opposite  to  the  epigastric,  passes  along  the  crest  of 
the  ilium  to  anastomose  with  the  ilio-lumbar,  gluteal,  lumbar,  and  epigas- 
tric arteries. 

Describe  the  Femoral  Artery.  It  extends  from  Poupart's  ligament  to  the 
opening  in  the  adductor  magnus,  where  it  becomes  the  popliteal  artery.  Its 
course  corresponds  to  a  line  drawn  from  a  point  midway  between  the  anterior 
superior  spine  of  the  ilium  and  the  symphysis  pubis,  to  the  inner  side  of  the 
inner  condyle  of  the  femur.  It  lies  in  a  strong  fibrous  sheath  with  the  femoral 
vein,  but  divided  from  the  latter  by  a  fibrous  partition.  It  bisects  Scarpa's 
triangle  in  the  upper  part  of  its  course,  where  it  is  superficial,  and  rests  on  the 
inner  margin  of  the  psoas,  which  separates  it  from  the  capsule  of  the  hip-joint 
Its  branches  are  as  follows  : — 


112 


ANATOMY. 


Superficial  EpigastricyC  to  the  superficial  fascia  of  the  abdomen. 

„  Superficial  Circumflex   Iliac.J  to    the   skin 

Fig.  59.  .u     -i-  . 

over  the  ihac  crest. 

Superficial  External  Fudic,d  to  the  integu- 
ment of  the  lower  abdomen,  penis,  and 
scrotum. 

Deep  External  Pudic,d  to  the  skin  of  the 
scrotum  and  perineum. 

Profunda  Femoris,e  arises  posteriorly  about 
I  or  2  inches  below  Poupart's  liga- 
ment, and  descends  to  the  lower  third  of 
the  back  of  the  thigh,  giving  off  the  fol- 
lowing branches : — 

Ext.  Circumflex.^     Int.  Circumflex./ 
3  Perforating.-^ 

Muscular  Branches,  k  to  the  sartorius  and 
vastus  internus. 

Anastomotica  Magna,  arises  from  the  femo- 
ral in  Hunter's  canal,  and  divides  into  a 
superficial  and  deep  branch,  the  latter 
anastomosing  around  the  knee-joint  with 
the  superior  external  and  internal  articu- 
lar arteries,  and  the  recurrent  tibial. 

Describe   the   Popliteal   Artery.     It  extends 

from  the  opening  in  the  adductor  magnus  to  the 

lower   border   of  the   popliteus   muscle,  where, 

having  passed  behind  the  knee-joint,  it  divides  into  the  anterior  and  posterior 

tibial  arteries.     Its  branches  are  as  follows  : — 

Superior  Muscular  Branches.  Superior  Internal  Articular. I 

Inferior  Muscular,  or  Sural.  Azygos  Articular. 

Cutaneous  Branches.  Inferior  External  Articular, 

Superior  External  Articular.  Inferior  Internal  Articular. 

These  are  distributed  around  the  knee-joint  in  a  free  anastomosis. 
The  azygos  branch  perforates  the  posterior  ligament  of  the  joint  to  reach  the 
internal  ligaments  and  the  synovial  membrane. 

Describe  the  Anterior  Tibial  Artery.  It  extends  from  the  bifurcation 
of  the  popliteal  to  the  front  of  the  ankle-joint,  where  it  becomes  the  Dorsalis 
Pedis.  It  passes  between  the  two  heads  of  the  tibialis  posticus,  over  the  upper 
«dge  of  the  interosseus  membrane  and   along  its  anteiior  surface,  resting  on 


THE  ARTERIES.  113 

the  tibia  for  its  lower  one-third.  It  is  accompanied  by  the  anterior  tibial  nerve 
close  to  it  externally,  and  is  crossed  below  by  the  tendon  of  the  extensor  pro- 
prius  pollicis.     Its  branches  are — 

Reairrent  Tibial.         Muscular.         External  and  Internal  Malleolar. 

Describe  the  Dorsalis  Pedis  Artery.  It  is  the  continuation  of  the  ante- 
rior tibial,  extending  from  the  front  of  the  ankle-joint  to  the  1st  interosseous 
space,  where  it  terminates  in  the  Dorsalis  Hallucis  and  the  Communicating. 
The  anterior  tibial  nerve  lies  close  to  its  outer  side.  Its  branches  are  as 
follows  : — 

Tarsea,  passing  outwards  along  the  tarsus. 

Metatarsea,  giving  off  3  interosseae,  and  they  7  digital. 

DorsaKs  Hallucis,  to  the  great  toe  and  the  inner  side  of  the  second  toe  by 
its  3  digital  branches. 

Communicating,  which  dips  down  into  the  sole  of  the  foot  in  the  1st  inter- 
osseous space  of  the  metatarsus,  to  inosculate  with  the  external  plantar; 
and  gives  off  2  digital  branches,  to  the  plantar  surface  of  the  great  and 
second  toes. 

Describe  the  Posterior  Tibial  Artery.  It  is  a  large  vessel,  extending 
from  the  bifurcation  of  the  popliteal  along  the  back  of  the  tibia  to  the  fossa 
below  the  inner  malleolus,  where  it  divides  into  the  Internal  and  External 
Plantar.  The  posterior  tibial  nerve  crosses  it  a  short  way  below  its  origin  and 
then  lies  close  to  its  outer  side  for  the  rest  of  its  course.  Its  branches  are  as 
follows : — 

Peroneal,  along  the  fibular  side,  giving  off  the  anterior  peroneal,  muscular 
branches,  and  the  nutrient  artery  of  the  fibula. 

Nutrient  of  the  Tibia,  the  largest  nutrient  artery  of  bone. 

Muscular  Branches,  to  the  posterior  muscles  of  the  leg. 

Communicating,  a.  branch  to  the  peroneal  artery. 

Internal  Calcanean  Branches,  to  the  heel  and  sole  of  the  foot 

Describe  the  Internal  Plantar.  This  artery  is  the  smallest  of  the  termi- 
nating branches  of  the  posterior  tibial,  and  passes  along  the  inner  side  of  the 
foot  and  great  toe. 

Describe  the  External  Plantar  Artery.  It  sweeps  across  the  plantar 
aspect  of  the  foot  in  a  curve,  the  convexity  of  which  is  directed  outwards  and 
forwards;  and  at  the  interval  between  the  bases  of  the  ist  and  2d  metatarsal 
bones  it  inosculates  with  the  communicating  branch  from  the  dorsalis  pedis, 
forming  the  Plantar  Arch,  or  the  Stirrup  Anastomosis.  It  gives  off  numerous 
muscular  branches,  and  the — 

Posterior  Perforating,  3  small  branches  passing  through  the  3  outer  interos- 
seous spaces. 

10*  H 


114  ANATOMY. 

Digital,  4  oranches  supplying  the  sides  of  the  3  outer  toes  and  the  outet 
side  of  the  2d  toe ;  its  inner  side,  together  with  the  great  toe,  being  sup- 
plied by  the  Digital  Branches  of  the  Dorsalis  Pedis  Communicating. 

Describe  the  Pulmonary  Artery.  It  alone  of  the  arteries  carries  venous 
blood,  which  it  conveys  from  the  right  side  of  the  heart  to  the  lungs.  It  is 
only  about  2  inches  long,  and  nearly  all  within  the  pericardium ;  arising  from 
the  right  ventricle  in  front  of  the  ascending  aorta,  passing  upwards  and  back- 
wards to  the  under  surface  of  the  arch  of  the  aorta,  where  it  bifurcates,  and  is 
connected  to  the  aorta  by  a  fibrous  cord,  the  remains  of  the  ductus  arteriosus 
of  the  foetus.     Its  terminal  branches  are  the — 

Right  and  Left  Pulmonary  Arteries,  the  latter  being  the  shorter  of  the  two; 
pass  horizontally  outwards  to  the  roots  of  their  respective  lungs,  where  each 
divides  into  two  branches,  which  again  and  again  subdivide  to  ramify  through- 
out the  lung  tissue  and  end  in  the  capillaries  of  those  organs. 

ARTERIAL    ANASTOMOSES. 

Describe  the  Anastomosis  around  the  Shoulder-joint.  It  is  formed  by 
the  following  ^  arteries,  viz. — 

Posterior  Scapular^  br.  of  transv.  colli.  Suprascapular,  br.  of  thyroid  axis. 

Subscapular,  br.  of  axillary.  Ant.  CircujJiJlex,  br.  of  axillaiy. 

Dorsalis  Scapulce,  br.  of  subscapular.  Post.  Circumjlex,  br.  of  axillary, 

Infraspinous,  br.  of  dorsalis  scapulae.  Acromial,  br.  of  acromio-thoracic. 

What  Arteries  Anastomose  around  the  Elbow-joint?     The — 
Superior  Profunda,  br.  of  brachial.  Radial  Recurrent,  br,  of  radial. 

Inferior  Profunda,  br.  of  brachial.         Recurrent  Interosseous,  br.  of  posterior 
Anastomotica  Magna,  br.  of  brachial,  interosseous. 

Posterior  Articular,  br.   of   superior      Anterior  Ulnar  Recurrent,  br.  of  ulnar, 
profunda.  Posterior  Ulnar  Recurrent,  br.  of  ulnar. 

What  Arteries  Anastomose  around  the  Hip-joint  ?     They  are  the 
Gluteal,  Iliolumbar,  and  Circumflex  Iliac,  with  the  External  Circuviflex. 
Obturator  and  Sciatic,  with  the  Internal  Circumflex. 
Comes  Nervi  Ischiadici,  with  the  Perforating  branches  of  the  Profunda. 

Name  the  Arteries  Anastomosing  around  the  Knee-joint.     The — 
Descending,  br.  of  ext.  circumflex.  Sup.  Int.  Articular,  br.  of  popliteal. 

Anastomotica  Magna,  br.  of  femoral.  Inf.  Ext.  Articular,  br.  of  popliteal. 
Inferior  Perforating,  br.  of  profunda.  Inf.  Int.  Articular,  br.  of  popliteal. 
Superior  Ext.  Articular, hx.  of  popliteal.  Recurrent  Tibial,  br.  of  anterior  tiljial. 

How  is  the  Collateral  Circulation  established  after  Ligature  of  tibte 
Carotid  or  Subclavian  ?     By  the  following  anastomoses,  viz. — 

Superior  Thyr-oid,  br.  of  external  carotid,  with  the  Inferior  Thyroidy  br.  of 
the  thyroid  axis,  from  the  subclavian. 


THE   VEINS.  115 

Arteria  Princeps  Ceruicisy  br,  of  occipital,  from  the  external  carotid,  with 
the  Vertebral,  br,  of  subclavian,  and  the  F?'ofunda  Cervicis,  br.  of  the 
superior  intercostal,  from  the  subclavian. 

What  is  the  Longest  Anastomosis  in  the  Body?  That  between  the 
subclavian  and  the  external  iliac  by  the  anastomosis  of  the  Superior  Epigastric, 
br.  of  the  internal  mammary,  with  the  Deep  Epigastric,  br.  of  the  external 
iliac. 

[The  circle  of  Willis  has  been  described  on  page  io6 ;  the  palmar  and  plantar 
arches  on  pages  io8  and  113  respectively;  and  the  anastomosis  on  the  mem- 
brana  tympani  on  page  105.] 

THE   VEINS. 

What  are  the  Veins  ?  Vessels  carrying  blood  towards  the  heart.  Their 
walls  are  composed  of  3  coats,  an  internal,  serous;  a  middle,  muscular;  and 
an  external,  fibrous.  They  all  carry  carbonized  or  venous  blood,  except  the 
pulmonary  veins,  which  bring  oxygenated  blood  to  the  left  side  of  the  heart. 
The  deep  veins  accompany  the  arteries,  generally  in  the  same  sheath,  and  are 
given  the  same  names.  The  secondary  arteries,  as  the  radial,  ulnar,  brachial, 
etc.,  have  each  two  veins,  called  Vence  Comites.  The  superficial  veins  are 
usually  unaccompanied  by  arteries,  and  lie,  as  a  rule,  between  the  layers  of 
the  superficial  fascia,  terminating  in  the  deep  veins.  Many  veins  are  so  irreg- 
ular in  their  origin  that  they  cannot  be  accurately  described ;  they  all  anasto- 
mose with  each  other  much  more  freely  than  do  the  arteries. 

What  are  Sinuses  ?  They  are  venous  channels,  differing  from  veins  in 
structure,  but  answering  the  same  purpose.  Those  of  the  cranium  are  formed 
by  the  separation  of  the  layers  of  the  dura  mater. 

How  are  the  Veins  divided  ?  Into  the  Pulmonary,  Systemic,  and  Portal 
Systems ;  the  latter  being  an  appendage  of  the  systemic,  its  capillaries  rami- 
fying in  the  liver. 

What  Veins  have  no  Valves?  The  venae  cavse,  hepatic,  portal,  renal, 
uterine,  ovarian,  cerebral,  spinal,  pulmonary,  umbilical,  and  the  very  small 
veins. 

Name  the  principal  Veins  of  the  Head  and  Neck.     They  are  the — 
(i.)  Exterior  veins.  (2.)  Veins  of  the  diploe  and  cranium. 

Facial.  Veins  of  the  Diploe.  Transverse  Sinus. 

Te?nporal.  Cerebral  and  Cerebellar.  Cavernous  Sinus. 

Internal  Maxillary.  Superior  Longitudinal  Sinus.      Occipital  Sinus. 

Temporo-maxillary .  Inferior  Longitudinal  Sinus.       Superior  Petrosal  Sinus 

Posterior  Auricular.  Straight  Sinus.  Inferior  Petroml  Sinus. 

Occipital.  Circular  Sinus.  Lateral  Sinus. 


116  ANATOMY. 

(3.)  Veins  of  the  neck  draining  the  above-named. 
External  Jugular^  terminating  in  the  subclavian  vein.* 
Posterior  Exte7-nal  Jugular,  opens  into  the  external  jugular. 
Anterior  Jugular^  enters  the  subclavian  vein  near  the  external  jugular. 
Internal  Jugular^  formed  by  the  junction  of  the  two  last-named  sinuses  at  the 
jugular  foramen,  and  uniting  with  the  subclavian  vein  to  form  the  innomi- 
nate, at  the  root  of  the  neck.     In  its  course  it  receives  the  facial,  lingual, 
pharyngeal,  superior  and  middle  thyroid  veins,  and  the  occipital. 
Vertebral,  descends  the  foramina  in  the  transverse  processes  of  the  cervical 
vertebrae,  and  empties  into  the  innominate  vein. 

Name  the  Veins  of  the  Upper  Extremity.  They  are  in  two  sets,  super- 
ficial and  deep.  The  deep  follow  the  arteries,  generally  as  venae  comites, 
beginning  in  the  hand  as  Digital,  Interosseous,  and  Palmar  veins,  they  unite 
in  the  Deep  Radial  and  Ulnar  which  unite  to  form  the  Ven(Z  Comites  of  the 
brachial  artery  at  the  bend  of  the  elbow.  The  superficial  veins  lie  in  the 
superficial  fascia;  they  are  as  follows: — 

^^^^^''^^ \  Median  Cephalic.     Cephalic.  \   .^,_  ,    „ 

Aledian |  [      VmN 

Anterior  and  Posterior  Ulnar ^  Median  Basilic.       Basilic.    J         ^^^• 

Name  the  principal  Veins  of  the  Thorax.     They  are  as  follows,  viz. — 
Internal  Mammary.  Bronchial.  Right  Azygos  [major). 

Inferior  Thyroid.  Mediastinal.  Left  Lower  Azygos  [minor). 

Intercostal.  Pericardiac.  Left  Upper  Azygos  [minimus). 

What  are  the  Azygos  Veins  ?  They  supply  the  place  of  the  venae  cavae  in 
the  region  where  these  trunks  are  deficient,  being  connected  with  the  heart. 
The  Right  Azygos'^''  begins  by  a  branch  from  the  right  lumbar  veins  usually, 
passes  through  the  aortic  opening  in  the  diaphragm,  and  ends  in  the  superior 
vena  cava,  having  drained  9  or  10  right  lower  intercostals,  the  vena  azygos 
minor,  the  right  bronchial,  oesophageal,  mediastinal,  and  vertebral  veins.  The 
Left  Lower  Azygos'^^  begins  by  a  branch  from  the  left  lumbar  or  renal,  passes 
the  left  crus  of  the  diaphragm,  crosses  the  vertebral  column  and  ends  in  the 
right  azygos,  having  drained  4  or  5  lower  intercostals.  The  Left  Upper  Azygos 
drains  2  or  3  left  intercostals  and  empties  into  either  of  the  other  two.  It  is 
often  wanting,  its  place  being  filled  by  the  left  superior  intercostal  vein.^i 

Name  the  Spinal  Veins.  They  may  be  arranged  into  4  sets,  as  follows, 
riz. — 

Medulli-spinal,  the  veins  of  the  spinal  cord,  which  lie  in  plexus  form  between 
the  pia  mater  and  arachnoid.  They  unite  into  2  or  3  small  trunks  near 
the  base  of  the  skull,  which  terminate  in  the  inferior  cerebellar  veins  or 
in  the  petrosal  sinuses. 


THE   VEINS. 


117 


Fig.  6o. 


VencB  Basis  Vertebrarum,  empty  into  the  anterior  longitudinal. 
Longitudinal,  in  two  plexuses,  anterior  and  posterior,  running  the  whole 

length  of  the  spinal  canal.     The  posterior  join  the  dorsi-spinal  veins,  the 

anterior  empty  into  the  vertebral,  intercostal,  lumbar,  and  sacral  veins  in 

their  various  regions. 
Dorsi-spinalf   form    a   plexus    around    the 

spines,  processes,  and  laminae  of  all  the 

vertebrae.    They  empty  into  the  vertebral, 

intercostal,  lumbar,  and  sacral  veins  in 

their  respective  regions. 
Describe  the  Subclavian  Vein.  It  is  the 
continuation  of  the  axillary,  extending  from 
the  outer  marg'n  of  the  1st  rib  to  the  sterno- 
clavicular articulation,  where  it  unites  with  the 
internal  jugular  to  form  the  innominate  vein. 
At  the  angle  of  junction  enters  the  thoracic 
duct  on  the  left  side  of  the  body  and  the  right 
lymphatic  duct  on  the  right  side.  In  its  course 
it  receives  the  external  and  anterior  jugular 
veins  and  a  branch  from  the  cephalic. 

Describe  the  Venae  Innominatae.  The 
two  innominate  veins  are  each  formed  by  the 
union  of  the  subclavian  and  internal  jugular, 
and  unite  below  the  1st  costal  cartilage  to 
form  the  superior  vena  cava.  The  Right  In- 
nominate is  about  I  ^  inch  long,  and  receives, 
besides  its  constituent  branches,  the  right  in- 
ternal mammary,  right  inferior  thyroid,  and 
right  superior  intercostal  veins.  The  Left  In- 
nominate"^ is  about  3  inches  long,  and  in  its 
course  it  receives  the  vertebral,  inferior  thy- 
roid, internal  mammary,  and  superior  inter- 
costal veins  of  the  left  side. 

Describe  the  Superior  Vena  Cava.^  It  is 
a  short  trunk  about  2^  or  3  inches  in  length,  formed  by  the  union  of  the  vense 
innominatae,  and  receives  all  the  blood  from  the  upper  half  of  the  body,  termi- 
nating in  the  right  auricle  of  the  heart.  It  is  half  covered  by  the  pericardium, 
and  receives  the  vena  azygos  major  and  small  pericardiac  and  mediastinal  veins. 

Name  the  Principal  Veins  of  the  Lower  Extremity.     They  are  in  two 
sets,  superficial  and  deep.     The  deep  are  the  Vence  Comites  of  the  anterior  and 


118  ANATOMY. 

posterior  tibial  and  peroneal  arteries,  which  collect  the  blood  from  the  deep 
parts  of  the  foot  and  leg,  and  unite  in  the — 

Popliteal,  which  becomes  the  Femoral,  and  it  the  External  Iliac  in  the  same 
manner  as  the  respectively-named  arteries. 
The  superficial  veins  of  the  lower  extremity  are  the — 

Internal  or  Long  Saphenous,  on  the  inside  of  the  leg  and  thigh,  enters  the 
femoral  at  the  saphenous  opening  i^  inch  below  Poupart's  ligament.  In 
its  course  it  receives  the  following : — 

Cutaneous  Branches.  Superficial  Circumflex  Iliac. 

Superficial  Epigastric,  Pudic.  Communicating  Branches. 

External  or  Short  Saphenous,  formed  by  branches  from  the  dorsum  and  outer 
side  of  the  foot,  it  ascends  behind  the  outer  malleolus,  up  the  middle  of 
the  back  of  the  leg,  and  empties  into  the  popliteal  vein. 

Describe  the  Internal  Iliac  Vein.io  It  is  formed  by  the  venae  comites  of  the 
branches  of  the  internal  iliac  artery,  except  the  umbilical.  It  terminates  with 
the  external  iliac,  at  the  sacro-iliac  articulation,  to  form  the  common  iliac  vein. 
It  receives  the  following  veins  : — 

Gluteal,     Internal  Pudic.      Hemorrhoidal  and  Vesico-       Uterine  and  Vagi- 
Sciatic.       Obturator.  prostatic,  in  the  male.  nal  Plexuses,  in 

the  female. 
Describe  the  Common  Iliac  Veins.^^  They  are  each  formed  by  the  union 
of  the  two  iliac  veins  as  above  described,  and  unite  between  the  4th  and  5th 
lumbar  vertebrae  to  form  the  inferior  vena  cava,  the  right  common  iliac  being 
the  shortest  of  the  two.  Each  receives  the  Ilio-lumbar,  sometimes  the  Lateral 
Sacral,  and  the  left  one  in  addition  the  Middle  Sacral  Vein,  which  sometimes 
ends  in  the  vena  cava. 

Describe  the  Inferior  Vena  Cava.^  It  extends  from  the  junction  of  the  two 
common  iliac  veins,  passing  along  the  front  of  the  spine,  through  the  tendinous 
centre  of  the  diaphragm,  to  its  termination  in  the  right  auricle  of  the  heart. 
It  receives  the  following  veins : — 

Lumbar.^"^  Renal)^  Phrenic. 

Right  Spermatic P  Supra-renal.  Hepatic}^ 

Describe  the  Portal  System.  The  portal  system  is  formed  by  the  Superior 
and  Inferior  Mesenteric,  Splenic,  and  Gastric  Veins,  which  collect  the  blood 
from  the  digestive  viscera,  and  by  their  union  behind  the  head  of  the  pan- 
creas form  the  Portal  Vein,  which  enters  the  transverse  fissure  of  the  liver, 
where  it  divides  into  2  branches,  and  these  again  subdivide,  ramifying  through- 
out that  organ,  therein  receiving  blood  also  from  the  branches  of  the  hepatic 
artery.  Its  contents  enter  the  inferior  vena  cava  by  the  hepatic  vein.  The 
portal  vein  is  about  4  inches  long,  receives  the  Gastric  and  Cystic  Veins,  and  is 


THE  ABSORBENTS.  119 

formed  by  the  union  of  the  superior  mesenteric  and  splenic  veins,  the  inferior 
mesenteric  joining  the  splenic,  which  also  receives  one  of  the  gastric,  the  other 
emptying  into  the  portal. 

Name  the  Cardiac  Veins.  They  return  the  blood  from  the  tissue  of  the 
heart  into  the  right  auricle.     They  are  the — 

Great  Cardiac  Vein.  Anterior  Cardiac  Veins. 

Posterior  Cardiac  Vein.  Vence  Thebesii. 

Coronary  Sinus,  is  a  dilatation  of  the  great  cardiac  vein,  receiving  the  pos- 
terior cardiac  and  an  oblique  vein  from  the  left  auricle. 

Describe  the  Pulmonary  Veins.  They  alone  of  the  veins  carry  arterial 
blood,  beginning  in  the  capillaries  of  the  lungs,  forming  a  single  trunk  for 
each  lobule,  which,  uniting  into  a  single  trunk  for  each  lobe,  form  two  main 
trunks  from  each  lung  which  open  separately  into  the  left  auricle.  Sometimes 
the  3  lobe-trunks  of  the  right  lung  remain  separate  to  their  termination  in  the 
auricle,  and  not  unfrequently  a  common  opening  serves  for  the  2  left  pulmo- 
nary veins. 

THE   ABSORBENTS. 

What  are  the  L3niiphatics  ?  They  are  very  delicate,  transparent  vessels, 
formed  of  three  coats  like  arteries  and  veins,  found  in  nearly  every  part  of  the 
body,  except  the  brain,  spinal  cord,  eyeball,  cartilage,  tendons,  membranes  of 
the  ovum,  placenta,  umbilical  cord,  nails,  cuticle,  hair,  and  bone.  They  are 
nourished  by  nutrient  vessels,  and  have  valves,  but  no  nerves,  so  far  as  known. 
They  convey  lymph  to  the  blood. 

What  are  the  Lacteals  ?  They  are  the  lymphatics  of  the  small  intestine, 
conveying  the  chyle  therefrom  into  the  blood. 

What  are  the  Lymphatic  Glands?  Small  solid  bodies  placed  in  the 
course  of  the  absoi'bent  vessels,  and  found  chiefly  in  the  mesentery,  along  the 
great  blood-vessels,  in  the  mediastina,  axilla,  neck,  front  of  the  elbow,  groin, 
and  popliteal  space.  The  lymphatics  and  lacteals  before  entering  these  glands 
break  up  into  smaller  branches,  the  afferent  vessels,  which  form  a  plexus  in 
the  gland,  and  pass  out  as  efferent  vessels  to  unite  again  in  one  trunk.  They 
also  contain  spheroidal  bodies  about  -j^V^  ^"^^  in  diameter.  These  glands 
are  named  after  the  regions  in  which  they  are  situated,  as  the  axillary,  inguinal, 
mesenteric,  etc. 

Describe  the  Thoracic  Duct.  It  is  the  main  channel  for  the  lymph  and 
chyle  from  the  whole  body  except  the  right  arm  and  lung,  right  side  of  the 
head,  heart,  neck,  and  thorax,  and  the  convex  surface  of  the  liver.  It  begins 
in  the  Receptaculum  Chyli,  in  front  of  the  2d  lumbar  vertebra,  passes  through 
the  aortic  opening  in  the  diaphragm,  and  at  the  upper  border  of  the  7th  cer- 


120  ANATOMY. 

rical  vertebra  it  curves  forwards,  outwards,  and  downwards,  terminating  in  the 
left  subclavian  vein  at  its  junction  with  the  internal  jugular. 

Describe  the  Right  Ljmiphatic  Duct.  It  is  about  an  inch  long,  termi- 
nating in  the  right  subclavian  vein  at  its  union  with  the  internal  jugular,  and 
draining  the  lymphatics  of  those  parts  which  are  not  connected  with  the  tho- 
racic duct. 

THE   NERVOUS   SYSTEM. 

How  is  the  Nervous  System  divided?  Into  the  Cerebrospinal,  or 
nervous  system  of  animal  life ;  and  the  Sympathetic,  or  nervous  system  of 
organic  life. 

What  is  the  Structure  of  the  Nervous  tissue  ?  It  is  formed  of  two 
substances  essentially  different  from  each  other,  the  White  or  fibrous,  and  the 
Gray  or  vesicular  matter.  Chemically  these  contain  phosphorized  fat,  albumen, 
and  water.  A  third  form,  the  Gelatinous,  is  yet  a  subject  of  disagreement 
among  authorities. 

Describe  the  White  Nerve-matter.  It  is  composed  of  a  number  of  tubes, 
each  consisting  of  a  central  Axis- cylinder,  surrounded  by  the  White  Substance 
of  Schwann,  and  this  again  enclosed  in  the  tubular  membrane,  or  Nerve-sheath. 
The  whole  arrangement  is  precisely  analogous  to  that  of  a  submarine  telegraphic 
cable.  A  bundle  of  such  tubes  is  invested  by  a  covering,  the  Neurilemma,  or 
perineurium,  and  is  called  a  Nerve,  and  is  nourished  by  a  minute  capillary 
system  of  blood-vessels. 

How  do  Nerves  terminate  ?  Sensory  nerves  end  peripherally  as  plexuses 
in  their  end-organs  in  the  tissues.  Motor  nerves  end  peripherally  in  muscles 
as  plexuses,  or  plates.     Their  central  termination  is  not  yet  understood. 

Of  what  does  the  Cerebro-spinal  system  consist?  Of  the  brain,  the 
spinal  cord,  the  ganglia,  and  the  cranial  and  spinal  nerves. 

THE    BRAIN. 

What  are  the  Membranes  of  the  Brain  ?  The  dura  mater,  the  arach- 
noid, and  the  pia  mater. 

Describe  the  Dura  Mater.  It  is  a  dense  fibrous  membrane  lining  the 
interior  of  the  skull,  and  forming  the  internal  periosteum  of  the  cranial  bones. 
It  is  continuous  with  the  dura  mater  of  the  spinal  cord,  and  is  attached  to 
many  parts  of  the  base  of  the  skull.  It  presents  the  following  for  exami- 
nation : — 

Falx  Cerebri,  an  arched  process  sent  into  the  longitudinal  fissure  of  the  brain, 
contains  in  its  upper  and  lower  margins  the  superior  and  inferior  longi- 
tudinal sinuses. 


THE   BRAIN.  121 

Tentorium  Cerebelli,  a  lamina  of  dura  mater  supporting  the  posterior  lobes  of 
the  brain,  and  covering  the  upper  surface  of  the  cerebellum.     It  incloses 
the  lateral  and  superior  petrosal  sinuses. 
Falx  Cerebelli,  projects  between  the  lateral  lobes  of  the  cerebellum,  from  the 

tentorium  to  the  foramen  magnum. 
Pacchionian   Bodies,  clusters  of  white  granulations  situated  on  the  outer 
and  inner  surfaces  of  the  dura  mater,  in  the  superior  longitudinal  sinus, 
and  on  the  pia  mater,  found  only  after  the  7th  year,  and  of  unknown 
function. 
Describe   the   Arachnoid.     It   is  the  serous  sac  which   forms   the   middle 
membrane,  having  a  visceral  and  a  parietal  layer,  the  latter  being  reflected 
over  the  interior  surface  of  the  dura  mater.     The  Anterior  Sub-arachnoid  Space 
is  the  interval  between  it  and  the  pia  mater  of  the  brain  at  the  base,  where  it 
is  extended  across  between  the  two  middle  lobes.     The  Posterior  Sub-arachnoid 
Space  is  a  similar  interval  between  the  hemispheres  of  the  brain  and  the  me- 
dulla oblongata.     These  spaces  communicate  together  across  the   crura  cere- 
bri ;  and  also  with  the  general  ventricular  cavity,  by  an  opening  in  the  lower 
boundary  of  the  4th  ventricle  ;  and  contain  the  cerebro-spinal  fluid  which  forms 
a  water-bed  for  the  nervous  centres.     The  sac  of  the  arachnoid  also  contains  a 
serous  fluid  in  small  quantity. 

What  is  the  Pia  Mater  ?  It  is  the  vascular  membrane,  being  supplied  by 
the  branches  of  the  internal  carotid  and  vertebral  arteries.  It  covers  the  sur- 
face of  the  brain,  dipping  down  into  all  the  sulci,  and  forms  the  velum  inter- 
positum  and  choroid  plexus  of  the  4th  ventricle ;  and  contains  lymphatics  and 
nerves. 

How  is  the  Brain  divided  ?  Into  the  cerebrum,  cerebellum,  pons  Varolii, 
and  medulla  oblongata.  Its  average  weight  in  the  male  adult  is  49^  oz.,  in 
the  female  44  oz.,  of  which  the  cerebrum  is  about  seven-eighths.  The  ex- 
treme weights  in  278  male  cases  were  65  oz.  and  34  oz., — in  191  female  cases, 
56  oz.  and  31  oz. 

Describe  the  principal  Lobes  and  Fissures  of  the  Cerebrum.  Each  lateral 
half  of  the  cerebrum,  or  hemisphere,  has  the  following  5  lobes  and  8  fissures, 
besides  many  of  less  importance. 

Frontal  Lobe,  bounded  internally  by  the  longitudinal  fissure,  below  by  the 
fissure  of  Sylvius,  and  posteriorly  by  the  fissure  of  Rolando. 

Parietal  Lobe,  extending  down  to  the  fissure  of  Sylvius,  and  antero- poste- 
riorly from  the  fissure  of  Rolando  to  the  parieto-occipital. 

Occipital  Lobe,  behind  the  parieto-occipital  fissure. 

Temporo-sphenoidal  Lobe,  lying  in  the  middle  fossa  of  the  skull,  and  bounded 
in  front  by  the  fissure  of  Sylvius. 
11 


122  ANATOMY. 

Central  Lobe,  or  Island  of  Reil,  lies  in  the  fissure  of  Sylvius,  covered  by  the 

frontal  and  temporo-sphenoidal  lobes. 
Longitudinal  Fissure,  separating  the  two  hemispheres. 
Fissure  of  Sylvius,  at  the  base  of  the  brain,  extending  outwards  on  each 

side,  and  dividing  into  2  branches,  an  ascending  and  a  horizontal  one. 

It  lodges  the  middle  cerebral  artery. 
Fissure  of  Rolando,  on  the  superior  surface,  extending  from  the  longitudi- 
nal fissure  about  its  centre,  downwards  and  forwards  towards  the  fissure 

of  Sylvius,  separating  the  frontal  and  parietal  lobes. 
Parieto-occipital  Fissure,  extends  from  the  longitudinal  fissure  outwards  for 

about   an   inch   between   the   parietal   and   occipital  lobes.     It  is  better 

marked  in  a  longitudinal  section  of  the  brain. 
Calloso-marginal  Fissure,  above  the  gyrus  fornicatus  on  the  inner  surface  of 

the  hemisphere. 
Transverse  Fissure,  between  the  middle  lobe  and  the  crus  cerebri,  at  the 

base  of  the  brain.     It  admits  the  pia  mater  to  the  lateral  ventricle. 
Calcarine  Fissure,  also  seen  on  the  inner  surface,  extending  from  the  lower 

end  of  the  parieto-occipital  fissure  outwards  to  the  posterior  border  of  the 

occipital  lobe. 
First  Temporo-sphenoidal  Fissure,  below  the  fissure  of  Sylvius,  on  the  lateral 

surface  of  the  brain. 

Name  the  principal  Convolutions  of  the  Cerebrum.  The  superior 
and  inner  surfaces  of  each  hemisphere  are  formed  of  convolutions  [^gyri)  with 
intervening  furrows  [sulci]  of  various  depths,  both  gyri  and  sulci  being  formed 
of  gray  matter  thus  arranged  to  enable  it  to  present  a  great  extent  of  surface. 
The  convolutions  are  not  uniform  in  all  brains  as  to  arrangement,  nor  are  they 
symmetrical  in  the  two  hemispheres.  The  most  constant  are  the  following : — 
Gyrus  Fornicatus,  the  convolution  over  the  corpus    callosum,  seen  on  the 

inner  surface,  arching  from  before  backwards. 
Convolution  of  the  Longitudinal  Fissure,  along  the  edge  of  that  fissure  on 
the  superior  surface,  curving  over  the  front  and  back  of  each  hemisphere, 
to  the  base  of  the  brain. 
Ascending  Frontal,  lies  in  front  of  the  fissure  of  Rolando. 
Ascending  Parietal,  lies  behind  the  fissure  of  Rolando. 

Angular  Gyrus,  or  Pli  Courbe,  around  the  posterior  end  of  the  first  temporo- 
sphenoidal  fissure. 
Many  other  convolutions  are  named  by  writers  on  the  localization  of  cere- 
bral functions,  such  as   the  temporo-sphenoidal,  occipital,  supra-marginal   con- 
volutions, etc.     Their  names  will  be  found  sufficiently  explanatory  of  their 
several  locations.     The  Cuneus,  Precuneus,  and  Paracentral  Lobule  are  names 


THE   BRAIN.  123 

gi/en  to  the  regions  between  the  calcarine,  parieto-occipital,  and  calloso-marginal 
fissures,  the  last-named  locality  lying  in  front  of  the  last-named  fissure. 

Name  the  Points  in  view  on  the  Inferior  Surface  of  the  Brain.     From 

before  backwards,  excluding  the  cranial  nerves,  are  the  following : — 

Longitudinal  Fissure,  its  anterior  portion. 

Corpus  Caliosum,  the  great  transverse  commissure  of  the  brain. 

Lamina  Cinerea,  a  thin,  gray  layer,  beneath  the  optic  tracts. 

Fissure  of  Sylvius,  between  the  anterior  and  temporo-sphenoidal  lobes. 

Anterior  Perforated  Space,  for  vessels  to  the  corpora  striata. 

Optic  Commissure,  formed  by  the  junction  of  the  optic  tracts. 

Tuber  Cinereum,  a  gray  lamina  behind  the  optic  commissure,  forming  part 
of  the  floor  of  the  3d  ventricle. 

Infundibulum,  a  hollow  process,  connecting  the  pituitary  cavity  with  the  3d 
ventricle  in  the  foetus.    ■■ 

Pituitary  Body,  a  vascular  bi-lobed  body,  of  glandular  structure,  projects 
from  the  infundibulum  into  the  sella  turcica  of  the  sphenoid. 

Corpora  Albicantia,  two  round,  white  eminences,  united  together ;  they  are 
the  anterior  crura  of  the  fornix  folded  on  themselves. 

Posterior  Perforated  Space  {Pons  Tarini),  for  vessels  to  the  optic  thalami. 

Crura  Cerebri,  or  cerebral  peduncles,  connect  the  cerebrum  with  the  cere- 
bellum, spinal  cord,  and  medulla  oblongata ;  containing  the  fibres  passing 
to  the  basal  ganglia.  They,  with  the  optic  tracts,  form  the  boundaries  of 
the  Inter-peduncular  Space. 

Pons  Varolii,  to  be  described  separately.     [See  page  1 27.] 

What  Ganglia  are  comprised  in  the  Brain  ?  Besides  the  gray  matter  of 
the  cerebral  hemispheres,  of  the  cerebellum,  and  of  the  medulla  oblongata, 
there  are  the  following  at  the  base  of  the  brain : — 

Olfactory  Bulbs.  Optic  Thalami.  Tuber  Annulare. 

Corpora  Striata.  Tubercula  Quadrigemina. 

Describe  the  Basal  Ganglia.     They  are  as  follows,  viz. — 
Olfactory  Bulbs  are  the  ganglia  of  the  sense  of  smell,  lie  one  on  each  side  of 

the  median  line,  upon  the  cribriform  plate  of  the  ethmoid,  and  are  connected 

with  the  hemispheres  by  the  Olfactory  Tracts. 
Corpora  Striata,  the  motor  ganglia,  are  situated  in  the  floor  of  the  lateral 

ventricles,  and  therefore  within  the  hemispheres.     Each  corpus  striatum 

has  a — 

Caudate  Nucleus, — the  intraventricular  part. 
Lenticular  Nucleus, — the  extraventricular  part. 
Internal  Capsule, — divides  these  two  parts. 
Optic  Thalami,  the  sensory  ganglia,  are  in  the  floor  of  the  lateral  ventricles. 


124  ANATOMY. 

behind  the  corpora  striata.  Each  thalamus  opticus  is  divided  into  an  anterioi 
tubercle  seen  in  the  lateral  ventricle,  and  a  posterior  tubercle  beneath  the 
fornix. 

Corpora  Quadrigemina,  or  Optic  Lobes  (2  nates  and  2  testes),  lie  beneath  the 
posterior  lobes,  near  the  union  of  the  cerebrum  and  cerebellum.  They  form 
two  single  ganglia  for  vision.     [Described  under  Meso-cephalon.] 

Tuber  Annulare,  a  ganglion  in  the  substance  of  the  pons  Varolii,  the  seat  of 
indistinct  sensation  probably. 

Name  the  Commissures  of  the  Brain.  These  connecting  bands  number  19 
(n  all,  of  which  10  are  longitudinal,  and  9  transverse  in  direction,  viz. — 

Longitudinal  Commissures.  Transverse  Commissures. 

Olfactory  Tracts.  Anterior  Commissure  of  3d  ventricle. 

Taenia  Semicircularis.  Middle  Commissure  of  3d  ventricle. 

Crura  Cerebri.  Posterior  Commissure  of  3d  ventricle. 

Processes  e  Cerebello  ad  Testes.  Corpus  Callosum. 

Peduncles  of  the  Pineal  Gland.  Optic  Commissure. 

Fornix.  Pons  Varolii. 

Infundibulum.  Fornix,  is  a  transverse  commissure  as 

Lamina  Cinerea.  well  as  a  longitudinal  one. 

Gyrus  Fornicatus.  Posterior  Medullary  Velum. 

Fasciculus  Unciformis.  Valve  of  Vieussens. 

What  are  the  Ventricles  of  the  Brain  ?  They  are  5  cavities,  each  of  which 
is  situated  as  follows  : — 

Two  Lateral  Ventricles,  within  the  substance  of  the  hemispheres. 

Third  Ventricle,  between  the  optic  thalami,  on  the  base  of  the  brain. 

Fourth  Ventricle,  between  the  cerebellum  and  the  medulla  oblongata. 

Fifth  Ventricle,  between  the  two  lateral,  in  the  septum  lucidum. 

Ventricle  of  the  Corpus  Callosum,  so  called,  is  merely  the  space  between  the 
upper  surface  of  that  commissure  and  the  margins  of  the  hemispheres 
above  {labia  cerebri^. 

The  Foramina  of  Monroe  connect  the  two  lateral  ventricles  with  the  3d ;  the 
Iter  e  Tertio  ad  Quartam  Ventriculum,  or  aqueduct  of  Sylvius,  connects  the 
3d  with  the  4th. 

Describe  and  bound  the  Lateral  Ventricles.  They  each  have  3  Cornua,  the 
anterior,  middle,  and  posterior,  and  are  bounded  as  follows: — 

Hoof, — the  corpus  callosum. 

Floor, — the  corpus  striatum,  taenia  semicircularis  or  horny  band  of  Tarinus, 
optic  thalamus,  choroid  plexus,  corpus  fimbriatum,  and  the  fornix. 

Internally, — the  septum  lucidum. 

Externally,  behind  and  in  front, — the  brain  substance. 


THE  BRAIN.  125 

What  are  the  parts  above-named?  Some,  as  the  corpus  striatum,  optic 
thalamus,  etc.,  have  been  described  aheady;  the  others  are — 

Corpus  Callosum,  the  great  transverse  commissure,  arching  backwards  to 
become  continuous  with  the  fornix,  reflected  below,  forming  the  Peduncles 
at  the  entrance  of  the  fissure  of  Sylvius;  and  marked  above  by  a  depres- 
sion, f/ie  Raphk,  and  longitudinal  elevations,  the  Stria  Longitudinales  or 
Nerves  of  Lancisi. 

Tcenia  Semicircularisy  consists  of  commissural  fibres  between  the  corpus 
striatum  and  the  optic  thalamus. 

Choroid  Plexus  of  Veins,  is  the  margin  of  a  fold  of  pia  mater  which  enters  at 
the  transverse  fissure,  passes  up  the  descending  cornu,  passes  through  the 
foramen  of  Monroe,  and  as  the  Velum  Interpositum  spreads  out  over  the 
roof  of  the  3d  ventricle. 

Corpus  Fimbriatum,  or  Tania  Hippocampi,  is  a  white  band,  the  edge  of  the 
posterior  pillar  of  the  fornix. 

Fornix,  is  a  commissure  situated  beneath  the  corpus  callosum,  but  continuous 
with  it  posteriorly,  the  Septum  Lucidum  separating  them  in  front.  It  is  of 
triangular  form  with  the  apex  in  front.  Its  Anterior  Crura  curve  down- 
wards to  the  base  of  the  brain,  are  there  reflected,  forming  the  Corpora 
Albicantia,  and  end  in  the  optic  thalami.  Its  Posterior  Crura  pass  down 
the  descending  horns  of  the  lateral  ventricles,  as  the  Hippocampi  Majores. 
The  Lyra  is  a  series  of  markings  on  its  under  surface. 

Septum  Lucidum,  consists  of  2  layers  of  white  and  gray  matter,  lined  by 
epithelium ;  is  placed  vertically  between  the  lateral  ventricles,  from  the 
raph6  of  the  corpus  callosum  above  to  the  fornix  below.  The  cavity  in 
its  centre  is  the  5th  ventricle. 

Describe  the  Comua  of  the  Lateral  Ventricles.  The  Anterior  Cornu 
curves  over  the  anterior  end  of  the  corpus  striatum  into  the  anterior  lobe. 
The  Posterior  Cornu  curves  downwards  and  inwards  in  the  occipital  lobe, 
and  contains  a  smooth  eminence,  the  Hippocampus  Minor.  The  Middle  Cornu 
descends  into  the  middle  lobe  to  the  transverse  fissure  at  the  base  of  the  brain, 
curving  backwards,  outwards,  downwards,  forwards,  and  inwards  (B.  O.  D. 
F.  I.).     On  its  floor  are  the  following : — 

Hippocampus  Major,  the  doubled-in  surface  of  the  gyrus  fornicatus. 

Pes  Hippocampi,  rounded  eminences  at  the  end  of  the  hippocampus. 

Pes  Accessorius,  or  Eminentia  Collateralis,  between  the  hippocampi,  at  the 
junction  of  the  middle  and  posterior  comua. 

Corpus  Fimbriatum,  a  continuation  of  the  posterior  pillar  of  the  fornix. 

Choroid  Plexus  of  Veins,  a  process  of  pia  mater,  already  described. 

Fascia  Dentata,  the  gray  serrated  edge  of  the  middle  lobe. 

Transverse  Fissure,  at  the  extremity  of  the  cornu,  extending  to  the  mediafl 
11* 


126  ANATOMY. 

line,  between  the  hippocampus  major  and  the  optic  thalamus.  It  opens 
at  the  base  of  the  brain  between  the  middle  lobe  and  the  crus  cerebri, 
and  admits  the  pia  mater  to  the  middle  cornu. 

Describe  and  bound  the  Third  Ventricle.  It  is  a  mere  fissure,  situated 
between  the  optic  thalami  in  the  median  line.  It  communicates  with  the 
lateral  ventricles  above  by  the  foramina  of  Monroe,  and  with  the  4th  ventricle 
behind  by  the  iter  e  tertio  ad  quartam  ventriculum.  It  is  crossed  by  3  bands, 
the  anterior,  middle,  and  posterior  commissures,  the  middle  one  being  of  gray 
matter,  the  others  of  white.  In  the  foetus  its  cavity  communicates  with  the  5th 
ventricle,  and  through  the  infundibulum  with  the  cavity  of  the  pituitary  body. 
It  is  bounded  as  follows  : — 

Roofy — the  velum  interpositum,  and  above  it  the  fornix. 

Floor, — the  parts  comprised  in  the  interpeduncular  space  at  the  base  of  the 
brain,  viz. — the  lamina  cinerea,  tuber  cinereum,  infundibulum,  corpora 
albicantia,  and  posterior  perforated  space. 

Anteriorly, — the  anterior  crura  of  the  fornix,  and  the  anterior  commissure 
of  the  ventricle. 

Posteriorly, — the  posterior  commissure,  and  the  iter  e  tertio,  etc. 

Laterally, —  the  optic  thalami  and  the  peduncles  of  the  pineal  gland. 

Describe  and  bound  the  Fourth  Ventricle.  The  fourth,  or  ventricle  of 
ilie  cerebellum,  lies  between  the  medulla  oblongata  and  the  cerebellum.  It  is 
considered  by  some  to  be  a  dilatation  of  the  central  canal  of  the  spinal  cord, 
and  is  enclosed  posteriorly  by  the  pia  mater ;  an  opening  in  which  admits  the 
entrance  and  exit  of  the  sub-arachnoid  fluid  from  the  sub-arachnoidean  space  of 
the  brain  and  spinal  cord,  and  a  fold  of  the  pia  mater  called  the  Choroid 
Plexus.  It  also  communicates  with  the  3d  ventricle  by  the  iter  e  tertio,  etc. 
Its  boundaries  are  as  follows : — 

Roof, — the  valve  of  Vieussens,  and  the  cerebellum. 

Anteriorly, — the  medulla  oblongata,  and  the  pons  Varolii. 

Posteriorly, — the  cerebellum. 

Laterally, — the  processus  e  cerebello  ad  testes,  the  posterior  pyramids  and 
the  restiform  bodies  of  the  medulla  oblongata. 

Floor, — the  posterior  median  fissure  of  the  medulla,  the  orifice  of  the  cen- 
tral canal  of  the  cord,  the  locus  ceruleus  and  taenia  violacea  (both  of  blue 
color),  the  fasculi  teretes  (2  spindle-shaped  elevations)  and  eminences  of 
origin  of  certain  nerves. 

Describe  the  Fifth  Ventricle.  It  is  situated  between  the  two  layers  of  the 
septum  lucidum,  and  therefore  between  the  lateral  ventricles.  Its  roof  is  formed 
by  the  corpus  callosum,and  in  the  foetus  it  communicates  with  the  3d  ventricle 
by  an  opening  between  the  pillars  of  the  fornix.     It  usually  contains  fluid. 


THE  BRAIN.  127 

What  is  the  Meso-cephalon  ?     It  comprises  the  parts  which  connect  the 

cerebrum  with  the  cerebelhim  and  the  medulla  oblongata,  and  includes  the 
following  structures,  viz  : — 

Pons  Varolii,  a  great  transverse  commissure  seen  at  the  base  of  the  brain 
in  front  of  the  medulla.  Its  fibres  connect  the  hemispheres  of  the  cere- 
bellum with  each  other  and  the  medulla. 

Crura  Cerebri,  or  Peduncles  of  the  Cerebrum,  extend  from  the  pons  to  the 
corpora  striata  and  optic  thalami,  and  consist  of  the  Peduncular  Fibres 
which  pass  from  the  medulla  to  the  ganglia  named,  and  thence  upwards 
to  the  gray  matter  of  the  hemispheres  as  the  Corona  Radiata.  Each  cms 
contains  in  its  centre  a  mass  of  gray  matter  called  the  locus  niger. 

Valve  of  Vieussens,  is  a  thin  lamina  forming  the  roof  of  the  iter  e  tertio  ad 
quartam  ventriculum,  and  stretched  between  the  two  processus  e  cerebello 
ad  testes.  Its  Frenulum  is  a  ridge  descending  on  its  upper  part  from  the 
corpora  quadrigemina. 

Corpora  Quadrigemina,  or  Optic  Lobes,  are  4  spherical  eminences  placed 
together  above  the  valve  of  Vieussens,  and  behind  the  3d  ventricle  be- 
neath the  posterior  border  of  the  corpus  callosum.  The  anterior  pair  are 
called  the  Nates,  the  posterior,  the  Testes,  and  they  are  connected  with  the 
optic  thalami  and  optic  tracts  by  4  bands,  their  Brachia ;  and  with  the 
cerebellum  by  a  white  cord  on  each  side,  the  Processus  e  Cerebello  ad  Testes. 
They  form  two  ganglia  for  the  centre  of  vision. 

Pineal  Gland,  is  a  small  conical  reddish  body  situated  between  the  nates,  on 
which  it  rests.  Its  4  peduncles  connect  it  with  the  anterior  crura  of  the 
fornix,  and  the  optic  thalami.  It  is  very  vascular,  and  has  a  small  cavity 
(said  to  communicate  with  the  3d  ventricle)  which  contains  a  viscid  fluid, 
and  some  concretions  formed  of  the  phosphates  of  lime,  magnesia,  and 
ammonia,  etc.,  called  the  Acervulus  Cerebri. 

Describe  the  Medulla  Oblongata.  This  ganglion  is  the  upper  enlarged 
part  of  the  spinal  cord,  extending  from  the  upper  border  of  the  atlas  to  the 
pons  Varolii.  Its  posterior  surface  forms  the  floor  of  the  4th  ventricle,  its 
anterior  surface  rests  on  the  basilar  groove  of  the  occipital  bone.  It  is  divided 
into  two  lateral  halves  by  the  Anterior  and  Posterior  Median  Fissures,  and  con- 
tains gray  matter  scattered  throughout  it,  from  which  the  cranial  nerves  from 
the  5th  to  the  12th  inclusive  arise  entirely  or  in  part.  In  it  are  supposed  to  lit 
the  centres  for  the  vaso-motor  and  the  cardiac  nerves,  also  centres  of  respira- 
tion, phonation,  deglutition,  mastication,  and  expression.  On  each  side  it  pre- 
sents the  following, — 

Anterior  Pyramid,  formed  by  the  anterior  and  lateral  columns  of  the  spinal 
cord. 


128  ANATOMY. 

Olivary  Body,  behind  the  pyramid,  from  which  it  is  separated  by  the  groove 
of  the  hypoglossal  nerve.  It  contains  a  capsule  of  gray  matter  in  its  cen- 
tre, the  Corpus  Deniahwi. 

Lateral  Tract,  continuous  with  the  lateral  column  of  the  spinal  cord,  lies 
behind  the  olivary  body  and  in  front  of  the  restiform. 

Restiform  Body,  the  posterior  lateral  portion  of  the  medulla,  also  called  the 
Fasciculus  Cuneatus. 

Posterior  Pyramid,  or  Fasciculus  Gracilis,  the  most  posterior  portion,  is 
formed  by  the  posterior  median  column  of  the  spinal  cord.  It  diverges 
from  its  fellow  at  the  apex  of  the  4th  ventricle  and  forms  the  lateral 
boundary  of  the  Calamus  Scriptorius. 

What  is  the  Cerebellum  ?  It  is  that  portion  of  the  brain  situated  in  the 
Inferior  occipital  fossae,  beneath  the  posterior  lobes  of  the  cerebrum.  It  is  an 
oblong  flattened  ganglion,  divided  into  two  lateral  hemispheres,  and  a  central 
portion,  the  Vermiform  Process. 

Name  the  Fissures  of  the  Cerebellum.  They  are  3  in  number, — 2  ver- 
tical and  I  horizontal,  viz. — 

Jncisura  Cerebelli  Anterior.  Great  Horizontal  Fissure,  from  which 

Incisura  Cerebelli  Posterior.  secondary  fissures  originate. 

Name  the  Points  on  the  surfaces  of  the  Cerebellum.     They  comprise  15 
lobes,  2  commissures,  and  3  projections,  as  follows : — 
On  the  upper  surface  of  each  hemisphere, — 

Anterior  or  Square  Lobe.  Posterior  or  Semilunar  Lobe. 

On  the  under  surface  of  each  hemisphere,  from  before  backwards, — 

Flocculus,  Sub-peduncular  Lobe,  or  Pneumogastric  Lobule. 

Amygdala  Lobe,  or  Tonsil,  projects  into  the  4th  ventricle. 

Digastric  Lobe.  Slender  L^obe.  Posterior  Lnferior  Lobe, 

On  the  vermiform  process  are  the — 

Lobulus  Centralis.       )  Pyramid. 

Monticulus  Cerebelli. 

Commissura  Simplex. 
The  Vallecula,  or  valley  of  the  cerebellum,  is  the  central  depression  on  its 

under  surface  between  the  two  lateral  hemispheres. 

Name  the  Peduncles  of  the  Cerebellum,  They  are  3  in  number  on  each 
side,  and  from  below  upwards  are  as  follows : — 

Processus  e  Cerebello  ad  Medullam,  to  the  medulla  oblongata. 
Processus  e  Cerebello  ad  Pontem,  connect  the  hemispheres. 
Processus  e  Cerebello  ad  Testes,  to  the  cerebrum. 

Describe  the  Gray  Matter  of  the  Cerebellum.     It  occupies  the  surface  of 


(Pyramid.  \ 

superiorly.  Uvula.  \  inferiorly. 

Commissura  Brevis.  ) 


THE  CRANIAL  NERVES.  129 

the  mass  in  laminated  shape,  and  is  traversed  by  curved  furrows,  between  the 
laminae.     A  vertical  section  gives  an  appearance  called  the  Arbor  Vitce. 

Corpis  Dentatum,  is  a  capsule  of  gray  matter  in  the  centre  of  the  white 
and  is  open  anteriorly.  It  is  sometimes  called  the  ganglion  of  the  cere- 
bellum. 

THE  SPINAL  CORD. 

Describe  the  Spinal  Cord.  It  is  that  part  of  the  cerebro-spinal  axis  which 
is  situated  in  the  spinal  canal.  Its  length  is  about  i6  inches,  terminating  at 
the  lower  border  of  the  ist  lumbar  vertebra  in  the  Cauda  Equina.  It  is  cylin- 
drical in  general  form,  with  2  enlargements,  one  in  the  cervical  region,  the 
other  in  the  lumbar.  It  is  composed  of  gray  and  white  matter,  the  gray  being 
inside  (instead  of  outside,  as  in  the  cerebrum),  and  arranged  so  as  to  present 
a  crescentic  appearance  in  horizontal  section,  joined  by  a  transverse  commis- 
sure, and  forming,  by  their  extremities,  the  Anterior  and  Posterior  Horns,  from 
which  regions  respectively  the  anterior  and  posterior  roots  of  the  spinal  nerves 
have  their  apparent  origin. 

Membranes  of  the  cord  are  3,  as  in  the  brain, — dura  mater,  arachnoid, 
and  pia  mater.  The  Dura  Mater  is  not  adherent  to  the  spinal  column, 
but  is  connected  thereto  by  fibrous  tissue.  The  Arachnoid  is  arranged  as 
on  the  brain,  its  sub-arachnoid  space  being  filled  with  its  fluid,  for  the 
protection  of  the  cord.  The  Pia  Mater  has  a  fibrous  band  on  each  side, 
the  ligamentum  denticulatum,  connecting  it  to  the  dura  mater  by  some  20 
serrations. 
Fissures,  number  8, — the  anterior  and  posterior  median,  the  anterior  and 
posterior  lateral  on  each  side,  and  the  two  posterior  intermediary  in  the 
cervical  region. 
Columns,  are  8  in  number,  4  on  each  side  of  the  cord, — an  anterior,  lateral, 
posterior,  and  posterior  median.  The  Anterior  is  continuous  with  the 
anterior  pyramid  of  the  medulla;  the  Lateral,  with  the  lateral  column  of 
the  medulla ;  the  Posterior,  with  the  resliform  body ;  the  Posterior-median, 
with  the  posterior  pyramid. 
Central  Canal,  or  Ventricle  of  the  Cord,  extends  through  its  entire  length  in 
the  foetus  and  in  some  adults,  but  is  usually  closed  except  for  one-half  inch 
below  its  orifice  in  the  floor  of  the  4th  ventricle. 

THE  CRANIAL  NERVES. 
Describe  each  Cranial  Nerve,  stating  its  function,  apparent  and  deep 
origin,  foramen  of  exit,  principal  branches  and  distribution.  There  are 
12  pairs  of  cranial  nerves  (9  according  to  Willis),  of -which  those  from  the  6th 
to  the  1 2th  inclusive  have  their  deep  origin  wholly  or  in  part  from  the  floor  of 
che  4th  ventricle.     They  are  the — 

I 


ISO 


ANATOMY. 


Fig.  6i.  ist,  Olfactory,   nerve  of  smel\,-^ 

arises  by  2  roots  from  the  anterior 
cerebral  lobe  and  i  root  from  the 
middle  lobe,  deeply  from  the  optic 
thalamus,  island  of  Reil,  corpus 
striatum,  and  anterior  commis- 
sure ;  exit  by  20  branches  through 
the  cribriform  plate,  to  the  Schnei- 
derian  membrane.  Its  bulb  is  a 
lobe  of  the  cerebrum. 
2d,  Optic,  nerve  of  sight, — arises 
from  the  optic  commissure^  and 
tracts,  deeply  from  the  optic  thal- 
amus, corpora  geniculata,and  cor- 
pora quadrigemina ;  exit  through 
the  optic  foramen  to  the  retina. 

[This  nerve  and  the  Optic  Tract  are 
more  fully  described  at  the  end  of  the 
volume,  under  the  sub-title,  Vessels 
AND  Nerves  of  the  Eye.] 

3d,Motor  Oculi,''  motor  of  the  eye, 
. — arises  from  the  crus  cerebri,  deeply  from  the  floor  of  the  iter  e  tertio  ad  quartam 
ventriculum ;  exit  through  the  sphenoidal  fissure,  to  all  the  muscles  of  the  orbit 

except  the  superior  oblique  and 
the  external  rectus,  also  to  the  iris. 
4th,  Patheticus,8  motor  of  the  eye, 
— arises  from  the  outer  side  of  the 
crus,  deeply  from  the  valve  of 
Vieussens;  ^jtzV  through  the  sphe- 
noidal fissure,  to  the  superior  ob- 
lique muscle  of  the  eye. 
5th,  Trigeminus,^  nerve  of  sensa- 
tion, motion,  and  taste, — arises  by 
two  roots, — from  the  side  of  the 
pons  Varolii,^  deeply  from  the 
pyramidal  body  (motor  root), 
lateral  tract  of  the  medulla,  the 
pons,  and  cerebelkim  (sensory 
root).  Exit  of  ophthalmic  divi- 
sion by  the  sphenoidal  fissure; 
of  superior  maxillary  by  the  fora- 
men  rotundum ;  of  inferior  max 


Fig.  62. 


THE  CRANIAL  NERVES.  131 

illary  division  and  motor  root,  l)y  the  foramen  ovale.     The  Gasserian  gan- 
glion^ is  situated  on  the  sensory  root  at  the  origin  of  its  three  divisions. 

Ophthalmic  Division,^  goes  to  the  forehead,  eyelids,  lachrymal  gland,  con- 
junctiva, iris,  ciliary  ganglion,  and  the  nose.     Its  branches  are — 
Frontal?  Lachrymal}^  Nasal}^ 

Superior  Maxillary  Division,^  goes  to  the  temple,  cheek,  lower  eyelid, 
nose,  lip,  upper  teeth,  and  to  Meckel's  ganglion,  thence  to  the  palate.  Its 
branches  are  the — 

Orbital  20  Posterior  Dental,  i «  3  7  /  1 6  i  nSS'"'*'  ' 

Spheno-palatine.  Anterior  Dental.^^  ^  '      (Labiai. 

Inferior  Maxillary  Division,^  includes  the  motor  branch,  and  is  therefore 
a  nerve  of  common  sensation,  motion,  and  special  sense  (taste).  Its  motor 
filaments  go  to  the  muscles  of  mastication;  its  sensory  to  the  auditory  meatus, 
to  the  otic  and  submaxillary  ganglia,  the  anterior  part  of  the  tongue,  the 
cheek,  teeth,  and  the  lingualis  muscle  (sensation).     Its  branches  are  the — 

Masseteric,  Auriculo-temporal.^  Gustatory. ^^  r  Mylo-hyoid.28 

Deep  Temporal  {2).      or  Posterior  Division,     Inferior  Dental.^^  \  {^cSj.  ^'■^• 

Buccal.  having  8  sub-branches.  I  Mental.25 

Pterygoid. 

6th,  Abducens,'®  motor  of  the  eye, — arises  from  the  medulla  oblongata,  deeply 
from  the  floor  of  the  4th  ventricle ;  exit  by  the  sphenoidal  fissure,  to  the  ex- 
ternal rectus  muscle  of  the  eye. 

7th,  Facial,  or  Portio  Dura,"  motor  of  the  face,  ear,  palate,  and  tongue, — 
arises  from  the  groove  between  the  olivary  and  restiform  bodies  of  the 
medulla,  deeply  from  the  floor  of  the  4th  ventricle.  Exit  by  internal  audi- 
tory meatus,  through  the  aqueductus  Fallopii,  and  stylo-mastoid  foramen,  to 
the  muscles  of  expression,  the  tongue,  muscles  of  the  ear  and  palate,  etc. 
It  communicates  with  the  carotid  and  meningeal  plexuses,  the  spheno-palatine 
(Meckel's)  and  the  otic  ganglia,  the  auditory,  great  auricular,  pneumogastric, 
glosso-pharyngeal,  and  5th  nerves.     Its  chief  branches  are  the — 

Gr^ajf  P^/frfj^/,  to  Meckel's  ganglion.  Digastric.      Stylo- hy aid. 
S^nall  Petrosal,  to  the  otic  ganglion.  t  Temporal. 

External  Petrosal,  to  the  meningeal  plexus.  Temporo-facial.    \  Malar. 
Tyjnpanic,  to  the  muscles  of  the  tympanum.  (.Inf-orbital. 

Chorda  Tyvtpani,  to  the  tongue,  etc.  Cervico-facial.      \  Supm-maxil . 
Posterior  Auricular ,  to  auricle  and  occiput.  (infra-maxil. 

8th,  Auditory,    or    Portio  Mollis    of  the   7th,'i    nerve  of  hearing, — arises 
just  external  to  the  facial,  deeply  from  the  floor  of  the    4th  ventricle ;  exit  by 
the  internal  auditory  meatus,  to  the  internal  ear.     Its  branches  are  two,  the — 
Vestibular^  to  the  vestibule.  Cochlear,  to  the  cochlea. 

[This  nerve  is  fully  .lescribed  at  page  225,  infk-a.l 


132  ANATOMY. 

gth,  Glosso-pharyngeal,i2  nerve  of  sensation  and  taste, — arises  from  the  me- 
dulla oblongata  behind  the  olivary  body,  deeply  from  the  floor  of  the  4th 
ventricle;  exit  by  the  jugular  foramen,  to  the  back  of  the  tongue  (taste),  the 
middle  ear,  the  tonsils,  and  pharynx.     Branches  are — 

Tympanic  (Jacobson's).  Pharyngeal.  Tonsillar. 

Carotid.  Muscular.  Lingual. 

zoth,  Pneumogastric,  or  Par  Vagum,!^  the  auriculo-laryngo-pharyngo-oesoph- 
ago-tracheo-pulmono-cardio-gastro-hepatic  nerve.  A  nerve  of  sensation  and 
motion,  probably  receiving  its  motor  influence  from  its  spinal  accessory.  Ii 
arises  from  the  medulla  behind  the  olivary  body  and  below  the  9th  nerve, 
deeply  from  the  floor  of  the  4th  ventricle;  exit  by  the  jugular  foramen,  to  the 
parts  indicated  by  the  above  euphonious  appellation,  supplying  sensation  to  the 
external  ear  and  larynx,  motion  to  the  other  parts.  Its  branches  are  the — 
Auricular  (Arnold's).        Recurrent  Laryngeal.  (Esophageal. 

Pharyngeal.  Cervical  and  Thoracic  Cardiac.     Gastric. 

Sttperior  Laryngeal.  Ant.  and  Post.  Pulmonary.  Hepatic. 

nth,  Spinal  Accessory^^  ^^q  the  pneumogastric), — motor  nerve, — arises  by  a 
double  origin  (i)  from  the  lateral  tract  of  the  medulla,  deeply  from  near  the 
floor  of  the  4th  ventricle;  (2)  from  the  lateral  tract  of  the  cord  by  several 
filaments,  as  low  as  the  6th  cervical  nerve,  deeply  from  the  anterior  gray 
horn  of  the  cord.  Exit  by  jugular  foramen,  its  spinal  portion  having  first 
entered  by  the  foramen  magnum,  to  the  sterno-cleido-mastoid  and  trapezius 
muscles,  com,municati7tg  with  the  pharyngeal  and  laryngeal  nerves  by  its 
accessory  portion  in  the  same  sheath  with  the  pneumogastric ;  also  with  the 
2d,  3d,  4th,  and  5th  cervical  nerves  by  its  spinal  portion.  Its  branches  are 
indicated  by  the  above-described  distribution. 

I2th,  H3^o-glossal,^3  (Nonus  or  9th  of  Willis),  motor  of  the  tongue, — arises 
by  10  to  15  filaments  from  the  groove  between  the  pyramidal  and  olivary 
bodies  of  the  medulla  oblongata,  deeply  from  the  floor  of  the  4th  ventricle ; 
exit  by  the  anterior  condyloid  foramen,  to  the  thyro-  and  genio-hyoid,  the 
stylo-,hyo-,  and  genio-hyo-glossus  muscles;  and  by  the  descendens  nonihra.x\ch 
to  the  sterno-hyoid,  sterno-thyroid,  and  omo-hyoid  muscles.  It  communi- 
cates with  the  pneumogastric,  sympathetic,  ist  and  2d  cervical,  and  gustatory 
nerves.     Its  branches  of  distribution  are  the — 

Descendens  Noni.  Afuscular.  Thvro-hyoid. 

What  Nerves  enter  the  Cranium  before  passing  out  of  it  ?  The  spinal 
portion  of  the  Spinal  Accessory,  and  the  Nasal  branch  of  the  Ophthalmic. 
The  first  enters  by  the  foramen  magnum,  and  then  leaves  by  the  jugular  fora- 
men. The  second  enters  from  the  orbit  by  the  anterior  ethmoidal  foramen, 
and  leaves  by  the  nasal  slit  at  the  side  of  the  crista  galli. 


THE  SPINAL   NERVES.  183 

THE   SPINAL   NERVES. 

Describe  the  Spinal  Nerves.  There  are  31  pairs  of  spinal  nerves,  of  which 
the  cervical  number  8,  the  dorsal  12,  the  luml)ar  5,  the  sacral  5>  and  the  coc- 
cygeal I.  The  1st  cervical  escapes  above  the  ist  vertebra,  each  of  the  others 
below  the  corresponding  vertebra  through  the  intervertebral  foramina.  Each 
nerve  arises  by  2  roots,  an  anterior  motor  root,  and  a  posterior  sensory  one, 
the  lattef  having  a  ganglion  on  it.  These  unite,  and  the  nerve  then  divides  into 
2  branches^  both  having  motor  and  sensory  fibres.  The  posterior  branches  are 
small  and  generally  unimportant ;  they  supply  the  muscles  and  integument  of 
the  back.  The  anterior  branches  supply  the  neck,  front,  and  sides  of  the 
trunk,  and  the  extremities,  uniting  in  various  regions  to  form  plexuses  from 
which  important  nerve-trunks  originate. 

How  is  the  Cervical  Plexus  formed  and  distributed  ?  It  is  formed 
by  the  anterior  branches  of  the  first  4  cervical  nerves,  and  rests  on  the  levator 
anguli  scapulae  and  scalenus  medius  muscles.  Its  branches  (10)  comprise  4 
superficial  to  the  integument  of  the  head  and  neck,  and  the  following  deep 
branches,  viz. — 

Phrenic.         Communicans  Noni.         2  Muscular.  2  Communicating. 

Describe  the  Phrenic  Nerve.  It  arises  by  3  heads  from  the  3d,  4th,  and 
5th  cervical,  descends  across  the  front  of  the  scalenus  anticus,  crossing  the  sub- 
clavian and  internal  mammary  arteries  in  the  middle  mediastinum,  and  is  dis- 
tributed to  the  inferior  surface  of  the  diaphragm.  It  is  often  called  the  Inter- 
nal Respiratory  Nerve  of  Bell.  It  sends  filaments  to  the  pericardium  and 
pleura,  and  communicates  with  the  plexuses  of  the  sympathetic  in  the  abdo- 
men. 

Describe  the  formation  and  distribution  of  the  Brachial  Plexus.  It 
is  formed  by  the  union  of  the  4  lower  cervical  nerves  and  the  ist  dorsal.  The 
5th,  6th,  and  7th  unite  into  one  trunk  externally  to  the  scalenus  medius,  as  also 
do  the  8th  cervical  and  1st  dorsal  behind  the  same  muscle.  Below  the  line  of 
the  clavicle  both  these  trunks  bifurcate  ;  the  two  adjacent  branches  unite  be- 
hind the  axillary  artery  making  the  Posterior  Cord,  and  the  remaining  2  form 
the  Outer  and  Inner  Cords,  referred  to  the  artery.  Each  of  these  cords  bifur- 
cates, but  the  2  adjacent  branches  of  the  outer  and  inner  cords  unite  over  the 
artery,  to  form  the  Median  Nerve,  leaving  4  other  branches,  the  Ulnar,  Mus- 
culo-cutaneous ,  Musculospinal,  and  Circumflex  Nerves,  the  last  2  being  de- 
rived from  the  posterior  cord. 

The  branches  of  the  brachial  plexus  are  as  follows,  viz. — 
Above  the  clavicle  are  given  off  4,  the — 

Communicating,  completing  the  phrenic  nerve. 

Muscular,  to  the  longus  colli,  scaleni,  rhomboidei,  and  subclavius  muscles 
12 


134  ANATOMY. 

Posterior,  or  Long  Thoracic,  external  respiratory  nerve  of  Bell,  to  the  ser«»<- 
tus  magnus,  arising  from  the  5th  and  6th  cervical. 

Suprascapular,  from  the  1st  trunk  of  the  plexus,  to  the  scapular  muscles. 
Below  the  clavicle  are  12,  the, — 

2  Anterior  Thoracic,  from  outer  and  inner  cords  to  the  pectoral  muscles. 

J  Subscapular,  from  the  posterior  cord,  to  the  subscapularis,  teres  major> 
and  latissimus  dorsi  muscles. 

Circumflex,  from  the  posterior  cord,  to  the  muscles  and  integument  of  the 
shoulder,  and  the  shoulder-joint. 

Musculo-cutaneous,  from  the  outer  cord,  to  the  forearm  externally,  piercing 
the  coraco-brachialis  muscle. 

Internal  Cutaneous,  from  the  inner  cord,  to  the  arm  and  forearm. 

Lesser  Internal  Cutaneous  (nerve  of  Wrisberg),  from  the  inner  cord  to  the 
inner  side  of  the  arm.  Is  sometimes  wanting,  sometimes  connected  with 
the  intercosto-humeral. 

Median,  from  outer  and  inner  cords,  passes  between  the  two  heads  of  the  pro- 
nator radii  teres,  supplying  the  pronators,  flexors,  first  2  lumbricales,  and 
the  integument  of  the  thumb,  2^  fingers,  and  the  radial  side  of  the  palm. 
Its  branches  are  all  in  the  palm,  the — 

Muscular.  Anterior  Interosseus.  Palmar  Cutaneous. 

Ulnar,  from  the  inner  cord,  passes  between  the  two  heads  of  the  flexor  carpi 
ulnaris  at  the  inner  condyle  of  the  humerus,  supplying  the  elbow-  and 
wrist-joints,  several  muscles,  and  the  palmar  and  dorsal  integument  of  the 
little  finger  and  half  of  the  ring  finger.     Branches  are  the — 
2  Articular.  Cutaneous.  Superficial  Palmar. 

Muscular.  Dorsal.  Deep  Palmar. 

Musculo-spiral,  from  the  posterior  cord,  accompanies  the  superior  profunda 
artery  and  vein  in  the  spiral  groove  of  the  humerus,  and  at  the  external 
condyle  it  divides  into  the  radial  and  posterior  interosseus  nerves.  Its 
branches  are — 

Muscular.         Cutaneous.         Radial.         Posterior  Interosseous. 
The  Radial  s,\\^\)\\Qs  the  outer  side  and  ball  of  the  thumb,  and  the  dorsal 

integument  of  2j4,  fingers. 
The  Posterior  Interosseus  supplies  all  the  muscles  on  the  back  of  the  fore- 
arm except  3,  and  also  sends  a  filament  to  the  wrist-joint. 

"What  is  the  Intercosto-humeral  Nerve  ?  It  is  the  lateral  cutaneous  branch 
of  the  2d  intercostal  (anterior  branch  of  the  2d  dorsal)  ;  it  pierces  the  external 
intercostal  muscle  and  crosses  the  axilla,  joining  with  a  filament  from  the  lesser 
internal  cutaneous  (nerve  of  Wrisberg),  and  supplying  the  skin  of  the  upper 
half  of  the  inside  of  the  arm. 


THE  SPINAL   NERVES. 


135 


Fig.  63. 


Describe  the  Lumbar  Plexus.     It  is  formed  by  coromunicating  loops  from 
the  anterior  branches  of  the  first  4  lumbar  nerves,  in  the  following  manner. 
From  the  First  lumbar  nerve  are  given  off  the — 
IHo-hypogastric,  to  the  abdominal  and  gluteal  regions. 
Ilio-inguinal,  to  the  inguinal  region,  and  the  scrotum. 
Communicating  Loop,  to  the  second  lumbar  nerve. 
From  the  Second  lumbar  nerve  are  given  off  the — 
External  Cutaneous,  to  the  integument  of  the  outside 

of  the  thigh. 
Genito-crural,  to  the  spermatic  cord  and  front  of  the 

thigh. 
Communicating  Branch,  to  the  third  lumbar  nerve. 
From  the  Third  and  Fourth  lumbar  nerves  are  given 
off  the  following  by  a  branch  of  origin  from  each, 
viz. — 

Obturator,  through  the  obturator  foramen  to  the  ex- 
ternal obturator  and  adductor  muscles  and  the  hip- 
and  knee-joints. 
Accessory  Obturator  (often  absent),  to  the  pectineus 

and  hip-joint. 
Communicating,  from  the  3d  lumbar  to  the  4th. 
Communicating,  from  the  4th  lumbar  to  the  5th. 
Anterior  Crural,  which  descends  through  the  psoas 
muscle,  and   beneath   Poupart's   ligament   to   the 
thigh,  where  it  divides  into  an  anterior  and  pos- 
terior division.     Its  branches  are, — 

To  the  Iliacus  muscle.  Long  Saphenous. 

To  the  Femoral  artery.  Muscular. 

Middle  and  Internal  Cutaneous.         Articular. 

Describe  the  Sacral  Plexus.'^  It  is  formed  by  the 
anion  of  the  upper  4  sacral  nerves'^  with  the  5th  lum- 
bar and  a  loop  from  the  4th,  the  two  latter  forming  the 
Lumbosacral  Cord  a  It  lies  upon  the  pyriformis  muscle 
4nd  gives  off  the  following  5  branches,  viz. — 

Superior  Gluteal,^  from  the  lumbo-sacral  cord,  sup- 
plies the  glutei  and  tensor  vaginae  femoris. 

Muscular  Branches,  to  the  pyriformis,  obturator  internus,  gemelli,  and  quad* 
ratus  femoris  muscles. 

Pudic,e  escapes  by  the  great  sacro-sciatic  foramen,  crosses   the  ischiatifl 


136  ANATOMY. 

spine,  and  re-enters  the  pelvis  by  the  lesser  sacro-sciatic  foramen,  supply 
ing  the  perineum,  anus,  and  genitalia. 

Small  Sciatic,/  to  the  gluteus  maximus,  and  integument  of  the  perineum, 
scrotum,  and  back  of  the  thigh  and  leg. 

Great  Sciatic,s  the  largest  nerve  ot  the  body,  and  the  direct  continuation 
of  the  sacral  plexus,  escapes  by  the  great  sacro-sciatic  foramen,  sends  an 
Articular  Branch  to  the  hip-joint,  Muscular  branches  to  the  adductor 
magnus,  semimembranosus,  semitendinosus,  and  biceps  muscles,  and  ter- 
minates in  the  External^  and  Internali  Popliteal  nerves,  generally  about 
the  lower  one-third  of  the  thigh. 

Describe  the  External  Popliteal  Nerve.  It  passes  from  the  bifurcation  of 
the  great  sciatic  along  the  outer  side  of  the  popliteal  space,  gives  off  Articular 
and  Cutaneous  branches,  and  about  an  inch  below  the  head  of  the  fibula  it 
divides  into  the — 

Anterior  Tibial,^  supplying  the  extensors,  and  the  integument  of  the  adja- 
cent sides  of  the  great  and  2d  toes. 
Musculo-cutaneous^n  by  2  branches  (internal  and  external)  to  the  peroneal 
muscles,  the  integument  of  the  ankles,  and  the  dorsal  integument  and 
sides  of  all  the  toes,  except  the  outer  side  of  the  little  toe  and  the  ad- 
joining sides  of  the  great  and  2d  toes. 

Describe  the  Internal  Popliteal  Nerve.  It  is  the  largest  of  the  two,  and 
descends  along  the  middle  of  the  back  of  the  leg,  becoming  the  Posterior 
Tibialk  at  the  lower  border  of  the  popliteus  muscle,  and  dividing  into  the 
External  and  Internal  Plantarl  below  the  inner  malleolus.  Its  branches  are 
as  follows : — 

Articular,  3  in  number,  to  the  knee-joint.  \ 

Muscular,  to  the  gastrocnemius,  soleus,  plantaris,  and  popliteus. 
External  or  Short  Saphenous,^  formed  by  a  filament  from  both  popliteal 
nerves,  supplies  the  integument  of  the  little  toe  and  outer  side  of  the  foot. 
Muscular,  to  the  tibialis  posticus,  flexor  longus  pollicis,  and  flexor  longus 

digitorum. 
Plantar  Cutaneous,  to  the  skin  of  the  heel  and  inner  sole  of  the  foot. 
Internal  Plantar,  to  the  inner  plantar  muscles,  sole  of  the  foot,  and  the 

plantar  integument  of  the  inner  3^  toes. 
External  Plantar,  to  the  external  plantar  muscles,  and  the  plantar  integu- 
ment of  the  outer  i^  toes. 

THE   SYMPATHETIC   NERVE. 

What  is  the  Sjnnpathetic  Nerve  ?  It  consists  of  a  series  of  ganglia  situated 
on  each  side  of  the  vertebral  column,  connected  together  and  to  the  cerebro- 


THE   SYMPATHETIC   NERVE.  137 

spinal  system  by  intervening  cords,  beginning  in  the  ganglion  of  Ribes  on  the 
anterior  communicating  artery,  and  ending  in  the  ganglion  impar,  in  front  of 
the  coccyx. 

Name  the  Ganglia  of  the  S5mnpathetic  in  the  Cranium  and  its  vicinity. 

They  are  9  in  number,  as  follows  :  — 

Ganglion  of  Ribes,  on  the  anterior  communicating  artery. 

Ganglion  of  Laumonier,  on  the  internal  carotid  artery. 

Ciliary,  or  Ophthalmic  Ganglion,  in  the  orbital  cavity. 

Sphenopalatine  [MeckePs)  Ganglion,  in  the  spheno-maxillary  fossa. 

Otic  [Arnold's]  Ganglion,  under  the  foramen  ovale. 

Submaxillary  Ganglion,  above  the  submaxillary  gland. 

Ganglion  of  Cloquet,  in  the  incisive  fossa,  on  the  naso-palatine  nerve. 

Ganglion  of  Bidder,  below  the  foramen  spinosum,  on  the  middle  meningeal 

artery. 
Ganglion  of  Bockdalek,  on  a  branch  between  the  spheno-palatine  ganglion 

and  the  anterior  dental  nerve  at  their  junction. 

Describe   the  Ganglia  connected  with   the   5th  Cranial   Nerve.     There 
are  4  such,  each  having  a  motor,  a  sensory,  and  a  sympathetic  root,  viz. — 

Ciliary,  or  Ophthalmic  Ganglion,  is  situated  in  the  orbit,  between  the  optic 
nerve  and  the  external  rectus  muscle.  Its  sensory  root  is  derived  from  the 
nasal  branch  of  the  ophthalmic,  its  motor  root  from  the  3d  nerve,  its 
sympathetic  root  from  the  cavernous  plexus.  Its  branches  are  the  short 
ciliaiy  nerves,  and  are  distributed  to  the  ciliary  muscle  and  the  iris. 

Spheno-palatine,  or  Meckel's  Ganglion,  is  a  large  ganglion  situated  in  the 
spheno-maxillary  fossa.  Its  sensory  root  is  derived  from  the  superior 
maxillary,  its  motor  root  from  the  facial  by  the  Vidian  and  large  petrosal, 
its  sympathetic  root  from  the  carotid  plexus,  by  the  carotid  branch  of  the 
Vidian.     Its  branches  are  the — 

Ascending.  Middle  Palatine. 

Anterior  Palatine.      Superior  Nasal.        Pharyngeal,  or 

Posterior  Palatine.     Naso-palatine.  Pterygo-palatine. 

Otic  Ganglion  [Arnold* s),  is  situated  on  the  inferior  maxillary  nerve,  imme 
diately  below  the  foramen  ovale.  Its  sensory  root  is  derived  from  the 
auriculo-temporal  branch  of  the  inferior  maxillary;  its  motor  root  from 
the  internal  pterygoid  branch  of  the  same,  also  from  the  facial  and  glosso^ 
pharyngeal  by  the  small  petrosal ;  its  sympathetic  root  from  the  middle 
meningeal  plexus.  Its  branches  are  distributed  to  the  tensor  palati  and 
tensor  tympani  muscles. 

Submaxillary  Ganglion,  is  situated  above  the  submaxillary  gland.     Its  sen- 
sory root  is  derived  from  the  gustatory  branch  of  the  inferior  maxillary, 
12* 


138 


ANATOMY. 


Fig.  64. 


its  motor  root  from  the  facial  by  the  chorda  tympani,  its  sympathetic  root  from 
the  facial  plexus.  Its  branches  are  distributed  to  the  submaxillary  gland,  its 
duct,  and  the  mucous  membrane  of  the  mouth. 

What  Nerves  appear  on  removing  the  Gasserian  Ganglion  ?  The 
three  Petrosal  Ijranches  of  the  7th  nerve  (see  page  131),  lying  on  the  petrous 
portion  of  the  temporal  bone,  and  communicating  with  the  sympathetic  system 
as  follows,  viz.,  the — 

Large  Superficial  Petrosal,^  (Great  Petrosal),— a  branch  of  the  7th  nerve, 

from  its  geniculate  ganglion, 2  (intu- 
mescentia  gangliformis),  which  passes 
through  the  hiatus  Fallopii,  and 
thence  through  the  foramen  lacerum 
medium  to  the  Vidian  canal,  where 
it  joins  the  large  deep  petrosal 
from  the  carotid  plexus,  to  form 
the  Vidian  nerve,  as  which  it  goes 
to  Meckel's  ganglion  (page  137), 
forming  its  motor  root. 
Small  Superficial  Petrosal,^  (Small  Pe- 
trosal), immediately  external  to  the 
preceding,  going  from  the  geniculate 
ganglion  of  the  7th  to  the  otic  gan- 
glion, and  lying  directly  over  the  tensor 
tympani  muscle. 
External  Superficial  Petrosal,'^  (External  Petrosal), — going  from  the  7th  to 
the  sympathetic  plexus  on  the  middle  meningeal  artery.^ 

Describe  the  Cervical  Ganglia.  They  are  3  in  number  on  each  side,  of 
which  the  superior  is  the  largest,  communicate  with  each  other,  and  are  as  fol- 
lows, viz. — 

Superior  Cervical  Ganglion^  lies  behind  the  carotid  sheath  opposite  the  2d 

and  3d  cervical  vertebras.     Its  branches  are  distributed  to  the  carotid, 

cavernous,  and  pharyngeal  plexuses,  and  one  of  its  internal  branches  is 

the  superior  cardiac  nerve  going  to  the  cardiac  plexus. 
Middle  Cervical  Ganglion^  on  the  superior  thyroid  artery,  opposite  the  5th 

cervical  vertebra,  and  gives  off  the  middle  cardiac  nerve  to  the  cardiac 

plexus,  also  communicating  branches. 
Inferior  Cervical  Ganglion^  on  the  superior  intercostal  artery,  between  the 

neck  of  the  1st  rib  and  the  transverse  process  of  the  7th  cervical  vertebra. 

It  gives  off  several  communicating  branches  and  the  inferior  cardiac  nerve 

to  the  cardiac  plexus. 


THE  SYMPATHETIC   NERVE.  139 

What  are  the  other  Ganglia  of  the  Sympathetic  ?  There  are 
on  each  side  of  the  vertebral  column  ii  or  12  dorsal  ganglia,  4  or  5 
lumbar,  5  sacral,  besides  the  single  coccygeal  Ganglion  Inipar  in  which 
terminates  the  double  chain.  Connected  with  the  viscera  are  many  ganglia, 
from  which  branches  ramify  around  the  arteries  in  plexuses  named  from 
their  locations. 

Describe  the  Splanchnic  Nerves.  They  are  3  in  number  on  each  side, 
and  are  derived  from  branches  of  the  6  lower  thoracic  ganglia,  as  follows, 
riz. — 

Great  Splanchnic,  from  branches  of  the  6th  to  the  loth,  connecting  with  the 
upper  six,  passes  through  the  posterior  mediastinum,  perforates  the  crus 
of  the  diaphragm,  to  the  semilunar  ganglion. 
Lesser  Splanchnic^  from  the  loth  and   nth,  passes  through  the  diaphragm 

with  the  great  splanchnic,  to  the  coeliac  plexus. 
Smaller  or  Renal  Splanchnic^  from  the  last  thoracic  ganglion,  also  perforates 
the  diaphragm,  and  ends  in  the  renal  and  coeliac  plexuses. 

Describe  the  Solar  Plexus.  This  plexus,  called  also  the  "  abdominal 
brain,"  is  a  network  of  nerves  and  ganglia,  chiefly  formed  by  the  splanchnic 
nerves  and  the  right  pneumogastric.  It  lies  behind  the  stomach,  and  in  front 
of  the  aorta  and  the  crura  of  the  diaphragm,  surrounding  the  coeliac  axis  and 
the  root  of  the  superior  mesenteric  artery.  Its  two  largest  ganglia  are  the 
Semilunar  Ganglia  situated  in  front  of  the  crura  of  the  diaphragm.  From  it 
are  derived  branches  which  form  Plexuses  over  most  of  the  abdominal  arteries, 
as  follows  : — 

Phrenic.       Gastric.  Splenic.  Renal.  Superior  Mesenteric. 

Coeliac.  Hepatic.         Suprarenal.     Spermatic.     Inferior  Mesenteric. 

Describe  the  Carotid  and  Cavernous  Plexuses.  They  are  two  plexuses 
of  the  sympathetic,  situated  on  the  internal  carotid  artery,  the  Carotid  lying  on 
the  outer  side  of  the  artery,  as  it  lies  by  the  side  of  the  body  of  the  sphenoid 
bone ;  and  the  Cavernous  being  on  the  inner  side  of  the  artery,  below  its  last 
bend,  in  the  upper  portion  of  the  cavernous  sinus.     The — 

Carotid  Plexus, — is  connected  by  numerous  filaments  with  the  6th  nerve 
"  and  the  Gasserian  ganglion,  and  furnishes  the  Large  Deep  Petrosal  to 
unite  with  the  large  superficial  petrosal  of  the  facial,  to  form  the  Vidian 
nerve ;  also  the  Small  Deep  Petrosal^  to  join  the  tympanic  plexus  prob- 
ably. 
Cavernous  Plexus, — communicates  with  the  3d  and  4th  nerves  and  the 
ophthalmic  division  of  the  5th,  and  gives  a  branch  to  the  Ciliary  ganglion 
in  the  orbit. 


140  ANATOMY. 

Mention  some  other  Plexuses  of  the  Sympathetic  system.  They 
are  very  numerous ;  besides  those  already  mentioned,  the  most  important  are 
the  following : — 

Tympanic  Plexus, — described  under  Nerves  of  the  Tympanum. 
Meningeal  Plexus,  on  the  middle  meningeal  artery. 
Facial  Plexus,  surrounding  the  facial  artery. 

Cardiac  Plexuses,  the  deep  in  front  of  the  bifurcation  of  the  trachea,  the 
superficial  in  front  of  the  right  pulmonary  artery ;    the  first  named  lies 
behind  the  arch  of  the  aorta,  the  latter  beneath  it. 
Coronary  Plexuses,  anterior  and  posterior,  accompanying  respectively  the 

left  and  right  coronary  arteries. 
Aortic  Plexus,  on  the  sides  and  front  of  the  aorta  between  the  superior  and 

inferior  mesenteric  arteries. 
Hypogastric  Plexus,  on  and  between  the  common  iliac  arteries ;  supplying 

the  viscera  of  the  pelvic  cavity. 
Inferior  Hypogastric  or  Pelvic  Plexuses,  two  in  number,  one  on  each  side 
of  the  rectum  and  bladder.     Their  branches  are  the — 

Inferior  Hemorrhoidal  Plexus.  Small  Cavernous  Nerve. 

Vesical  and  Prostatic  Plexuses.  Large  Cavernous  Nerve. 

Vaginal  Plexus.  Uterine  Nerve. 

What  is  the  Vidian  Nerve  ?  It  has  generally  been  described  as  a  branch 
of  the  spheno-palatine  (Meckel's)  ganglion  (see  p.  137),  running  backwards 
through  the  Vidian  canal,  and  dividing  into  a  Petrosal  Branch  to  the  P^acial 
nerve,  and  a  Carotid  Branch  to  the  carotid  plexus  of  the  Sympathetic.  It  is 
now,  however,  more  correctly  described  as  a  short  nerve  of  communication, 
between  the  Facial  and  the  Sympathetic  on  the  one  hand,  and  the  Spheno- 
palatine Ganglion  on  the  other,  supplying  that  ganglion  with  its  motor  and 
vaso-motor  roots.     It  is  formed  by  the  junction  of  the — 

Large  Superficial  Petrosal,  Br.  of  the  Facial  (p.  138),  with  the — 
Large  Deep  Petrosal,  Br.  of  the  Carotid  Plexus  (p.  140),  which  occurs  in 
the  cartilage  filling  in  the  foramen  lacerum  medium  (p.  35).  It  then  enters 
the  Vidian  Canal  (p.  20),  in  the  pterygoid  process  of  the  sphenoid  bone,  pass- 
ing through  which  to  finally  join  the  posterior  part  of  the  spheno-palatine  gan- 
glion (p.  137).     Some  filaments,  the — 

Upper  Posterior  Nasal  Branches, — are  apparently  given  off  from  the  Vidian 
in  the  canal,  to  the  septum  and  roof  of  the  nose ;  but  they  are  really 
branches  from  the  ganglion-,  bound  up  in  the  same  sheath  with  the  Vidian 
nerve. 


VISCERAL  ANATOMY. 


What  is  a  Viscus  ?  Viscus,  gen.  visceris,  pi.  viscera,  is  a  term  which  is 
applied  to  any  internal  organ  of  the  body.  The  Viscera  are  the  organs  con- 
tained in  the  three  great  cavities — cranium,  thorax  and  abdomen — with  their 
appendages.  Of  these  the  Heart  and  Brain  have  been  described,  with  the 
circulatory  and  nervous  systems  respectively.  \^See  pp.  99,  120;  alsG  the 
CoMPEND  OF  Physiology  in  this  series.] 

THE  DIGESTIVE  ORGANS. 

What  is  the  Alimentary  Canal  ?  A  musculo-membranous  tube,  from  25 
to  30  feet  in  length,  extending  from  the  mouth  to  the  anus,  lined  throughout 
with  mucous  membrane,  furnished  with  several  accessory  organs,  and  perform- 
ing the  functions  of  ingestion,  digestion,  and  egestion. 

Name  its  Subdivisions.  They  are  the  Mouth,  Pharynx,  (Esophagus, 
Stomach,  Small  Intestine  (duodenum,  jejunum  and  ileum)  and  Large  Intestine 
(caecum,  colon  and  rectum).  The  first  three  lie  above  the  diaphragm,  the  rest 
below  it. 

Name  the  Accessory  Organs  of  Digestion.  They  are — the  Teeth, 
Salivary  glands  (parotid,  sub- maxillary,  sub-lingual),  Liver,  Pancreas  and 
Spleen. 

THE  TEETH. 

What  are  the  Teeth  ?  They  are  32  organs  of  digestion  (20  being  tempo- 
rary, or  milk-teeth),  situated  one-half  in  each  jaw,  imbedded  in  the  alveolar 
processes,  and  partly  surrounded  by  the  Gumsy  which  are  composed  of  fibrous 
tissue  and  covered  with  mucous  membrane.  In  each  half  of  each  jaw  there 
ire — 

Temporary  Teeth  (5) — 2  Incisors,  i  Canine,  2  Milk-molars. 

Per?nanent  Teeth  (8) — 2  Incisors,  I  Canine,  2  Bicuspids,  3  Molars. 

What  are  their  General  Characteristics  ">     Each  tooth  presents  a — 
Crcnvn,  or  Body, — the  part  seen  projecting  above  the  gum. 
Neck, — the  constricted  portion  between  the  crown  and  the  fang. 
Fang,  or  Root, — imbedded  in  the  alveolus  ;  and  surrounded  by  the  periodental 

membrane  or  periosteum  lining  the  alveolus. 

141 


142 


VISCERAL  ANATOMY. 


Fig.  65. 


Pulp-cavity, — in  the  interior,  opening  at  the  apex  of  the  fang  for  the  entrance 
of  vessels  and  nerves. 

State  the  Characteristics  of  each  class  of  Teeth. 

Incisors,  or  Cutters. — Crown  chisel-shaped,  beveled  posteriorly.     Fang  single, 

long,  thickest  antero -posteriorly. 
Canines,  or  Tearers, — Crown  thick  and  conical.     Fang  longest  and  thickest 
of  all  the  teeth,  forming  a  projection  on  the  alveolar  arch.     The  2  upper 
canines  are  the  "  eye-teeth." 
Bicuspids, — Crown  has  2  cusps.     Fang  single  but  grooved  deeply,  showing  a 
marked  tendency  to  bifurcate. 

Molars,  or  Grinders, — Crown  large,  low  and 
cuboid  in  shape,  has  4  cusps  on  upper  molars, 
5  on  the  lower  ones.  Fangs  multiple,  usually 
3  on  the  first  two  upper  molars,  2  on  the  first 
two  lower  ones;  the  third  molar  of  either  jaw, 
having  but  one  fang,  is  called  the  "  wisdom 
tooth,"  and  is  the  smallest  of  the  three. 
The  2d  or  3d  Temporary  Molar  \s,  larger  than  the 
first. 

Describe  the  Structure  of  a  Tooth.     Each 

consists  of — 

Dentine  or  Ivory, "^ — composed  of  tubules  sur- 
rounded by  the  inter-tubular  tissue  or  Matrix, 
and  opening  into  the  pulp  cavity.  It  resembles 
compact  bone  in  appearance  and  in  composi- 
tion, consisting  of  28  parts  Animal  matter  and 
72  Earthy  matter.  The  Tubules  are  delicate 
wavy  canals,  diameter  about  ^-^(5"  ^^  ^'^  inch, 
which  branch  outwardly  and  anastomose  with 
each  other,  forming  concentric  shadings  or 
Schreyer''s  Lines. 

Enamel,^ — covers  the  crown;  consists  of  very 
dense  tissue,  which  contains  but  3)^  per  cent,  of 
animal  matter.  It  is  covered  by  a  very  delicate 
epithelial  cuticle,  Nasmyth's  Membrane,  which 
when  intact  withstands  the  action  of  acids. 
Crusta   Petrosa   or    Cement,'^ — the  enamel  of  the   fang;  is  a  layer  of  true 

bony  tissue,  containing  lacunae,  canaliculi,  and  Haversian  canals. 
Pulp, — fills  the  pulp-cavity  and  is  prolonged  into  the  dental  tubules;  is  soft, 
vascular,   and   sensitive;   and   consists   of  connective   and   fibrous   tissue, 


THE   TEETH.  143 

nucleated   cells,   blood-vessels   and    nerves.     The    cells  are    caudate   and 

anastomose   with   each   other,   those   situated    superficially   being   termed 

Odontoblasts. 

What  Arteries  and  Nerves  supply  the  Teeth  ?  The  Arteries  are 
derived  from  the  inferior  dental,  and  from  the  alveolar  and  infraorbital 
branches  of  the  internal  maxillary.  The  Nerves  are  derived  from  the  inferior 
dental  branch  of  the  inferior  maxillary  division  of  the  5th,  and  also  from  the 
anterior  and  posterior  dental  branches  of  the  superior  maxillary  divisii/ii  of 
the  same  nerve. 

When   do   the   Temporary   Teeth   appear  ?     Their  eruption    begins 

about  the  7th  month  after  birth,  with  the  central  incisors,  and   ends  with  the 

appearance  of  the  second  molars,  about  the  age  of  two  years.     The   lo\Srer 

teeth  slightly  antedate  the  upper.     Their  formula  is  as  follows  : — 

Mo.      Mo.     Ca.       In.       In.      In.       In.      Ca.      Mo.     Mo. 
f  Upper...     iiiiiiiiii     =     lo'l 

(Lower...     iiiiiiiiii     =     loj 
24        12         18  9  7  7  9         18        12        24  months. 

When  do  the   Permanent   Teeth  appear  ?     The  first  molars   appear 

about  the  end  of   the  6th  year,  followed  by  the  incisors  about  the  7th  or 

8th  year,  the  bicuspids  from  the  9th  to  the  loth  year,  the  canines  about  the 

iith  or  1 2th  year,  the  second  molars  from  the   12th  to  the  13th  year,  and  the 

third  molars  from  the   17th  to  the   25th  year.     Those  of  the  lower  jaw  a^-e 

slightly  in  advance  of  the  corresponding  upper  ones.     Their  formula  is  as 

follows : — 

Wis.  Mo.  Mo.  Bi.  Bi.  Ca.  In.  In.  In    In.  Ca.  Bi.  Bi.  Mo.  Mo.Wis. 
I"  Upper.       iiiiiiiiiiiiiiii  =  16'^ 

\- _______    —    ___    —    —    —    __  U2. 

(^  Lower.       iiiiiiiiiiiiiiii  =  16) 
18     12      6     10      9     II       8       7      7      8     II      9     10      6     12     18  years. 

What  is  the  greatest  Number  of  Teeth  at  one  time  in  the  jaws,  and 
when  ?  Forty-eight,  namely,  all  the  temporary  and  permanent  teeth  except 
the  third  molars, — occurring  between  the  5th  and  7th  years  of  age. 

Describe  the  Development  of  the  Teeth.  They  arise  from  the  mucous 
membrane  covering  the  maxillary  arches,  in  which,  about  the  6ih  foetal  week, 
appears  a  depression,  the  Primitive  Dental  Groove^  from  the  floor  of  which 
arise  papillce  of  mucous  membrane  to  form  the  pulp  of  the  milk-teeth. 

In  the  Follicular  Stage^  membranous  septa  form  across  the  groove,  and  its 
margins  become  thick  and  prominent. 

The  Saccular  Stage  extends  from  the  13th  week  to  the  i6th,  and  is  marked 
first  by  the  projection  of  the  papilloe  from  the  follicles^  next  by  the  growth  of 
the  follicular  margins,  the  formation  of  processes  or  Opercula  thereon,  which 
meet  and  close  in  the  papillae ;  and  finally  by  the  closing  in  of  the  dental 


144  VISCERAL  ANATOMY. 

groove  by  the  union  of  its  margins.  A  Cavity  of  Reserve  for  each  tooth  is 
then  formed  by  the  closure  of  the  secondary  dental  groove,  from  the  floor  of 
which  another  papilla  arises  to  form  the  germ  of  the  permanent  tooth. 

The  dental  pulps  now  take  the  forms  of  teeth,  a  thin  lamina  of  dentine 
appears  and  increases  from  without  inward,  the  enamel  organ  and  membrane 
are  formed,  and  when  calcification  has  advanced  sufficiently,  the  pressure  of 
the  teeth  causes  the  absorption  of  the  gum  above  them,  the  septa  ossify  and 
the  eruption  of  the  teeth  occurs.  The  Cement  is  formed  from  the  periodental 
membrane,  at  a  later  period  of  life. 

THE  MOUTH. 
Describe  the  Mouth.     It  is  an  oval  cavity  formed  by  the  lips,  cheeks, 
jaws,  palate  and,  tongue,  forming  the  superior  portion  of  the  alimentary  canal, 
and  opening  posteriorly  into  the  pharynx  by  the  fauces.     It  presents  the  teeth 
(already  described),  the  tongue  (to  be  described),  and  also  the — 
Hard  Palate,  formed  by  the  palate  processes  of  the  superior  maxillary  and 
palate  bones,  and  covered  with  mucous  membrane ;  forms  the  roof  of  the 
mouth. 
Soft  Palate,  formed  by  5  muscles  on  each  side,  viz.,  the  levator  palati,  tensor 
palati,   palato-glossus,   palato-pharyngeus,   and     the    azygos    uvulae;— the 
latter  forming  with  its  fellow  the  Uvula,  a  descending  muscular  projection. 
Anterior  Pillars  of  the  Fauces, — arch  downwards  and  forwards  to  the  base  of 

the  tongue,  and  contain  the  palato  glossi  muscles. 
Posterior  Pillars  of  the  Fauces,— zxch.  downwards  and  backwards  to  the  sides 

of  the  pharynx,  and  contain  the  palato-pharyngei  muscles. 
isthmus  Faucium, — the  space  bounded  by  the  pillars,  the   free  border  of  the 

palate,  and  the  base  of  the  tongue. 
Tonsils, — are  small,  elongated,  glandular  bodies,  situate  done  on  each  side  of 
the  fauces,  between  the  anterior  and  posterior  pillars.     Each  has  12  or  15 
Fig.  66.  openings  on  its  surface  leading  to 

follicular  depressions  within  the 
gland,  and  lies  close  to  the  inter- 
nal carotid  artery. 
Openings  of  Siena's  Ducts, — from 
the  parotid  glands,  are  situated 
internally  one  on  each  cheek, 
opposite  the  2d  upper  molar  tooth. 
Openings  of  Wharton's  Ducts, — 
from  the  sub-maxillary  glands, 
one  at  each  side  of  the  frenum  of 
the  tongue. 


THE  TONGUE. 


145 


Openings  of  the  Ducts  of  Rivinus, — 8  to  i8  on  each  side  from  the  sublingual 
glands,  near  the  frenum  of  the  tongue.  The  longest  is  the  Duct  of 
Bartholine,  which  opens  into  the  duct  of  Wharton, 

Where  are  the  Salivary  Glands  ?  The  Parotid  Gland'^  lies  below  and 
in  front  of  the  external  ear, — the  Sub -maxillary^  and  Sub-lingual^  Glands 
lie  in  the  corresponding  fossae  on  the  inner  surface  of  the  inferior  maxillary 
bone.     [See  Fig.  66.] 

Describe  the  Tongue.  The  tongue  consists  of  extrinsic  and  intrinsic 
muscles,  a  hyoglossal  membrane  and  a  mucous  membrane,  a  median  fibrous 
septum,  vessels  and  nerves.  Its  Base  is  attached  to  the  hyoid  bone,  the  epi- 
glottis, the  soft  palate  and  the  pharynx.  Its  Under  Surface  \^  attached  to  the 
hyoid  bone  and  the  inferior  maxillary.  Its  mucous  membrane  is  reflected 
over  the  floor  of  the  mouth  to  the  inner  surface  of  the  gums,  forming  in  front 
a  fold,  the  Frenum  Lingutz. 

The  Tongue  presents — 
Filiform  Papilla;,  along  its  sides,  closely  packed  in  rows. 
Fungiform  Papillce,"^  scattered  over  the  anterior  two-thirds  of  its  dorsum. 
Circumvallate  Papillcs,^  7  to  12  in  number,  in  two  rows,  forming  a  V  at 
the  base  of  the  tongue,  meeting  at  the  Foramen  Ccecum,  which  contains 
the  central  papilla.  Fig.  67. 

Follicular  Glands,    posteriorly  to  the  circum- 

vallate  papillae. 
Racemose  Glands,  over  the  dorsum,  sides,  and 
under  surface.     Beneath  the  tip  they  form 
two  small  oblong  m.asses. 
Extrinsic  Muscles,  are  the  stylo-,  hyo-,  genio- 
hyo-,  and  palato-glossus  muscles.     [See  pp. 

73,  74-] 
Intrinsic  Muscles,  are  the  several  fibres  of  the 
lingualis    muscle, — superior,   inferior,  trans- 
verse and  perpendicular. 
Name  the  Arteries  of  the  Tongue.    They 
are  the — 
/.ingual,  branch  of  the  external  carotid, — with  its 
branches,  the — 

Dorsal  is  linguae.     Sub-lingual.     Ranine. 
Sub-mental,  branch   of  the  facial, — anastomoses 

with  the  sub-lingual. 
Ascending  Pharyngeal,  branch  of  the  external  carotid, — sends  some  small 
branches  to  the  pharynx  and  tongue. 
J 


148  VISCERAL   ANATOMY. 

What  Nerves  are  distributed  to  the  Tongue  ?     The — 

Gustatory  Branch  of  the  §th, — to  the  mucous  membrane  of  the  sides  and 
anterior  two- thirds  of  the  tongue,  endowing  it  with  general  sensibiHty. 

Chorda  Tympani  Branch  of  the  yth, — ^joins  the  gustatory,  and  is  distributed 
to  the  same  region,  being  the  nerve  of  taste  for  the  anterior  two-thirds  of  the 
tongue. 

Lingual  Branches  of  the  gth  or  Glosso-pharyngeal, — to  the  mucous  membrane 
of  the  base  and  sides  of  the  tongue,  being  the  nerve  of  taste  for  its  poste- 
rior third. 

Hypoglossal,  or  12th, — to  the  intrinsic  and  extrinsic  muscles  of  the  tongue, 
being  its  nerve  of  motion. 

Superior  Laryngeal  Branch  of  the  loth  or  Pneumogastric, — sends  a  few 
fibres  to  the  base  of  the  tongue  from  its  internal  branch. 

What  special  Anatomical  Features  are  presented  by  the  Mouth? 
They  are  as  follows,  viz. — the — 

Hamular  Process  of  the  Sphenoid  Bone, — may  be  felt  behind  the  last  upper 

molar  tooth  ;  also  the  Internal  Pterygoid  Plate,  and  part  of  the  Pterygoid 

Fossa. 
Coronoid  Process,— o{  the  lower  jaw,  its  anterior  border. 
Posterior  Palatine  Artery, — at  inner  side  of  the  last  upper  molar  tooth,  and 

in  front  of  the  hamular  process. 
Gustatory  Nerve, — very  near  the  last  lower  molar  tooth. 
Pierygo-maxillary  Ligament, — felt  as  a  fold  posteriorly  to  the  last  lower 

molar  tooth. 

THE   PHARYNX. 

Describe  the  Pharynx.  It  is  a  conical,  musculo-membranous  bag,  about 
4^  inches  long,  hung  base  up  from  the  basilar  process  of  the  occipital  bone, 
and  extending  to  the  lower  border  of  the  cricoid  cartilage  posteriorly,  or  the 
5th  cervical  vertebra,  where  it  becomes  continuous  with  the  oesophagus.  ^  It 
forms  the  part  of  the  alimentary  canal  which  lies  behind  the  mouth,  being 
incomplete  in  front. 

What  are  its  Relations  ?     It  is  connected  with — 
Posteriorly, —  the  longus  colli  and  recti  capitis  antici  muscles,  and  by  loose 

areolar  tissue  to  the  first  5  cervical  vertebras. 
Laterally, — the  styloid  processes  and  their  muscles,  the  pterygoid  muscles,  the 

internal  carotid  arteries,  the  internal  jugular  vein,  the  8th,  9th,  and  the 

sympathetic  nerves. 
Near  its  Apex, — the  lobes  of  the  thyroid  gland,  the  common   carotid   and 

lingual  arteries,  the  sterno-hyoid  muscle,  and  the  lingual  nerves. 


THE  CESOPHAGUS. 


147 


What  are  its  Anterior  Attachments  ? 
The  internal  pterygoid  plate,  pterygo  maxillary 
ligament,  lower  jaw,  base  of  the  tongue,  cor- 
nua  of  the  hyoid  bone,  stylo-hyoid  ligament, 
thyroid  and  cricoid  cartilages  of  the  larynx. 

Name  the  Openings  into  the  Pharynx. 
They  are  7,  viz. — 

2  Posterior  Nares,  ^      ,         Larynx. 

2  Eustachian  Tubes.  (Esophagus. 

Describe  its  Structure.  The  pharynx  is 
composed  of  3  coats, — a  mucous,  a  muscular 
and  a  fibrous,  the  latter  lying  between  the 
other  two,  and  sometimes  called  the  Pharyn- 
geal Aponeurosis.  The  mucous  coat  is  covered 
with  ciliated  columnar  epithelium  above  the 
level  of  the  floor  of  the  nares — below  that 
level  by  squamous  epithelium  ;  and  contains 
simple  follicular  glands,  also  compound  folli- 
cular and  racemose  glands,  the  latter  being 
most  numerous  in  the  upper  part,  between  the 
two  Eustachian  tubes. 

Name  its  Muscles,  Arteries  and  Nerves. 
Its— 

Muscles,   5, — are   the    Superior,   Middle   and 

Inferior  Constrictors,  Stylo-pharyngeus,  and 

Palato- Pharyngeus.     [See  pages  73,  74.] 
Arteries  number  4,  as  follows, — 

Superior    Thyroid  Branches. ")  Branches  of 

Ascending  Pharyngeal.  /  Ext.  Carotid. 

Pterygo-palatine.  1    ^^        ,         r  ,     -r  ,  ,,     .„ 

T^  1  •       T^  ,    •  >-    Branches  of  the  Internal  Maxillary. 

Descendmg  Palatme.  J  ^ 

Nerves, — Branches  of  the  Pharyngeal  Plexus,  which  is  formed  by  the 
pharyngeal  branches  of  the  pneumogastric,  glosso-pharyngeal,  superior 
laryngeal,  and  superior  cervical  ganglion  of  the  sympathetic. 


THE  CESOPHAGUS. 
Describe  the  (Esophagus.     It  is  a  musculo-membranous  tube,  about  p 
inches  long,  extending  from  the  5th  cervical  vertebra  and  the  lower  border  of 
the  cricoid  cartilage  of  the  larynx,  through  the  oesophageal  opening  in  the 


148 


VISCERAL  ANATOMY. 


diaphragm  to  the  cardiac  orifice  of  the  stomach,  opposite  the  9th  dorsal 
vertebra,  where  it  terminates.  It  lies  in  the  neck,  between  the  trachea  and 
the  vertebral  column,  resting  in  part  on  the  longus  colli  muscle;  then 
inclining  to  the  left  side  it  reaches  the  posterior  mediastinum  behind  the  left 
bronchus. 

Describe  its  Structure.     The  CEsophagus  has  three  coats,  a — 

Mucous, — in  thick  longitudinal  folds,  containing  compound  racemose  glands, 
and  covered  with  a  thick  layer  of  squamous  epithelium. 

Cellular, — forms  a  loose  connection  between  the  other  two  coats,  and  con- 
tains the  CESophageal  vessels. 

Muscular, — having  longitudinal  fibres   externally,  circular  fibres  internally, 
which  are  continuous  with  the  fibres  of  the  stomach  below,  and  with  those 
of  the  inferior  constrictor  muscle  above. 
Name  its  Vessels  and  Nerves.     The  CEsophageal — 

Arteries^  are  chiefly  branches  from  the  thoracic  aorta. 

VeinSf  empty  into  the  vena  azygos  minor. 

Nerves,  are  branches  of  the  pneumogastric  and  the  cervical  sympathetic,  form- 
ing the  CEsophageal  Plexus. 

THE  STOMACH. 
Describe  the  Stomach.  It  is  the  principal  organ  of  digestion,  pyriform 
in  shape,  of  musculo-membranous  structure,  about  12  inches  long  by  4  inches 
in  average  diameter,  held  in  position  by  the  lesser  omentum,  and  situated 
diagonally  across  the  upper  abdomen,  in  the  epigastric  and  right  and  left  hypo- 
chondriac regions,  above  the  transverse  colon,  below  the  liver  and  diaphragm. 
It  presents  for  examination  a — 

Fundus  or  Splenic  End,  c — connected  to  the  spleen  by  the  gastro-splenic 
omentum.     (See  under  Peritoneum.) 

Pylorus  or  Lesser  End, — lies 
in  contact  with  the  anterior 
wall  of  the  abdomen,  the 
under  surface  of  the  liver, 
and  the  neck  of  the  gall- 
bladder, its  position  being 
near  the  end  of  the  carti- 
lage of  the  8th  rib. 
Greater  Curvature,^  — is  con- 
vex, and  is  connected  to  the 
colon  by  the  gastro-colic 
omentum.  (See  under  Peri- 
toneum.) 


THE  STOMACH. 


149 


Lesser  Curvature,  i  — is  concave,  and  connected  to  the  liver  by  the  gastro- 
hepatic  omentum,  and  to  the  diaphragm  by  the  gastro- phrenic  ligament. 

(Esophageal  Orifice,  ^ — is  situated  between  the  fundus  and  the  lesser  curva- 
ture.    It  is  funnel-shaped,  and  the  highest  part  of  the  organ. 

Pyloric  Orifice,  k — opens  into  the  duodenum,  ^and  is  guarded  by  the  circu- 
lar muscular  fibres  of  the  pylorus,  w^hich  are  aggregated  into  a  circular 
ring,  projecting  into  the  cavity,  and  with  its  covering  fold  of  mucous 
membrane,  forming  the  Pyloric  Valve. 

Describe  its  Structure.     The  Stomach  has  3  coats,  a — 
Mucous  Coat,  g — lined  with  columnar  non-ciliated  epithelium,  covered  with 
polygonal  Alveoli,  j^q  of  an  inch  in  diameter,  containing  the  orifices  of  the 
Gastric  Follicles.    When  the  stomach  is  contracted  the  mucous  membrane  lies 
in  longitudinal  folds  or  Rugce,  ^  one  of  which  aids  in  forming  the  valve  at 
the  pyloric  orifice. 
Cellular  or  Sub-mucous  Coat, — contains  the  gastric  vessels. 
Muscular  coat,f—cor&^s^.%  of  longitudinal,  circular,  and  oblique  fibres.      The 
Longitudinal  are  continuous  with  those  of  the  oesophagus  and  small  intes- 
tine, and  are  the  most  superficial.      The  Circular  lie  deeper,  and  over  the 
whole  organ  ;  they  form  a  sphincter  valve  around  the  pyloric  orifice.     (See 


Fig.  70. 


above.)      The   Oblique 

Fibres      lie      deepest, 

forming  two  sets  around 

the  oesophageal  open- 
ing, in  continuation  of 

the   circular  fibres     of 

the  oesophagus. 

The  Serous  Invest- 
ment of  the  stomach  is 
derived  from  the  perito- 
neum, and  covers  the 
whole  external  surface, 
excepting  the  points 
where  the  gastro- splenic, 
greater  and  lesser  omenta 
are  attached.  It  is  usu- 
ally, but  incorrectly,  described  as  a  fourth  coat  of  the  stomach. 

Describe  the  Gastric  Glands.     They  are  of  3  kinds,  the — 
Peptic  Follicles, — situated  all  over  the  stomach,  but  most  numerous  towards 
the  splenic  end, — are  tubules  lined  with  columnar  epithelium  in  their  upper 
one-fourth,  and  filled  with  nucleated  cells  in  their  deepest  parts. 


150  VISCERAL  ANATOMY. 

Simple  Solitary  Glands  are  found  scattered  along  the  lesser  curvature,  and 
nv:ar  the  pyloric  tnd. 
Name  the  Vessels  and  Nerves  of  the  Stomach.    Its  Arteries  are  the 


Pyloric^  ^ 

\  Branches  of  the  Hepatic  Artery  ' 
Right   Gastro-epij>loic'>^      '  ^ 


-epiploic^ '^  ^    I 
J 


Left  Castro-  ^ 

'     \  Branches  of  the  Splenic  Artery.  ^  "* 
Vasa  Brevia ' " 

Veins,  terminate  in  the  splenic  and  portal  veins. 

Nerves,  are  terminal  branches  of  the  right  and  left  pneumogastrics,  and  branches 
of  the  semilunar  ganglia  of  the  sympathetic,  forming  the  Gastric  Plexus. 

THE  SMALL  INTESTINE. 

Describe  the  Small  Intestine.  It  is  a  convoluted,  tubular,  digestive 
organ,  about  20  feet  in  length,  held  to  the  spinal  column  by  the  mesenteric 
portion  of  the  peritoneum,  and  divided  into  3  parts,  the — 

Duodenum, — about  12  fingers  (10  inches)  long,  ascends  for  2^  inches  to 

f.  the  under  surface  of  the  liver  and  the 

r IG.  71. 

neck   of  the   gall-bladder, — descends 
for  2i%  inches  in  front  of  the  right 
kidney, — and  passes  transversely  for  4 
inches  to  the  left,  across  the  spinal 
column,  to  the  left  side  of  the  second 
lumbar  vertebra,  where  the  superior 
mesenteric  artery  crosses  its  junction 
with   the  jejunum.     The   duodenum 
has  no  mesentery,  is  partially  covered 
with  peritoneum,  and  surrounds  the 
head  of  the  pancreas.     Into  its  descending  portion  open  the   ductus 
communis  chol6dochus/  and  the  pancreatic  duct. 
fejunum, — about  two- fifths  of  the  rest  of  the  small  intestine,  its  coils  lying 
around  the  umbilical  region.     It  is  named  from  the  fact  that  it  is  tisually 
found  empty  {Jejunus)  after  death. 
Ileum, — comprises  the  remainder  of  the  small  intestine  ;  is  named  from  its 
twisted  course,  lying  below  the  umbilicus,  and  terminating  in  the  right 
iliac  fossa,  at  the  ileo-csecal  valve,  or  valve  of  Bauhin. 
What  Coats  has  the  Small  Intestine  ?    Three,  a  mucous,  a  sub-mucous 
or  cellular,  and  a  muscular  coat.     Its  peritoneal  investment  is  sometim.es  da- 
scribed  as  a  fourth  coat,  but  incorrectly.     The — 


THE   LARGE  INTESTINE.  161 

Mucous  Membrane, — is  covered  with  columnar  non-ciliated  epithelium,  and 
thrown  into  crescentic  transverse  folds,  the  Valvulce  Conniventes,  or  valves 
of  Kirkring.  It  also  presents  numerous  vascular  projections  or  Villi,  each 
formed  of  basement  membrane,  epithelium,  a  lacteal  vessel,  a  capillary 
plexus,  granular  corpuscles,  and  longitudinal  muscular  fibres,  and  number- 
ing about  four  millions  in  the  whole  length  of  the  intestine. 

Cellular  Coaly — contains  the  vessels  of  the  intestine,  and  connects  the  other 
two  coats  together. 

Muscular  Coat, — consists  of  external  longitudinal  and  internal  circular 
fibres,  the  former  being  thinly  distributed  along  the  bowel,  the  latter  form- 
ing a  thick  layer,  but  not  making  complete  rings. 

Describe  the  Glands  of  the  Small  Intestine.  The  mucous  membrane 
of  the  small  intestine  contains — 

Crypts  of  LieberkUhUy  or  Simple  Follicles, — are  minute  tubular  depressions, 
found  all  over  the  intestine  and  also  in  the  stomach. 

B runner' s  Glands, — are  small  conglomerate  glands,  found  only  in  the  duo- 
denum and  the  first  part  of  the  jejunum,  being  most  numerous  near  the 
pylorus.     In  structure  they  resemble  the  pancreas. 

Solitary  Glands, — are  lymphoid  organs,  situated  throughout  the  intestine, 
though  most  numerous  at  the  lower  portion  of  the  ileum.  They  are  agmi- 
nated  into  some  20  or  30  oval  patches,  named — 

i'eyer's  Patches,— on  the  surface  opposite  to  the  mesenteric  attachme  its, 
some  of  which  are  as  much  as  4  inches  in  length.  They  are  most  numer- 
ous and  largest  in  the  ileum,  and  are  most  developed  during  digestion. 

THE  LARGE  INTESTINE. 
Describe  the  Large  Intestine.  It  is  about  five  feet  long,  of  large  calibre, 
sacculated,  consists  of  the  same  coats  as  the  small  intestine,  the  mucous  being 
smooth,  and  without  villi,  the  muscular  having  its  longitudinal  fibres  collected 
into  3  narrow  bands,  producing  a  pouching  of  the  tube.  It  presents  the  fol- 
lowing PARTS  Q.ndipointSf  viz. — 

CfECUM,  or  Caput  Ccecum  Coli,c — a  dilated  blind  pouch  behind  the  entrance 
of  the  small  intestine.*  It  is  the  beginning  of  the  large  intestine,  lies  in 
the  right  iliac  fossa,  and  is  two-thirds  covered  by  peritoneum. 
Appendix  Vermiformis,  ^ — a  blind  prolongation  about  3  to  6  inches  long, 
narrow  and  worm-like,  directed  backwards  and"  upwards  from  the  lower 
part  of  the  caecum,  being  retained  by  a  fold  of  the  peritoneum. 
lleo-ccecal  Valve,  or  Valve  of  Bauhin, — guards  the  entrance  of  the  small 
intestine,  being  formed  by  two  crescentic  folds  of  the  mucous  and  cellular 
coats  and  circular  muscular  fibres,  each  covered  with  villi  on  the  side 
toward  the  ileum,  but  smooth  on  the  caeca!  side. 


162 


VISCERAL  ANATOMY. 


Ascending  Colon, — extends  upwards  to  the  under  surface  of  the  liver,  where 

it  forms  the  Hepatic  Flexure  of  the  Colon. 
Transverse  Colon,  d—  crosses  the  abdominal  cavity  just  below  the  liver,  gall- 
bladder, stomach  and  spleen,  to  the 
left  hypochondrium,  where   it   ter- 
minates in  the  Splenic  Flexure  oj 
the  Colon. 
Descending  Colon,  e — passes  down- 
wards in  front  of  the  left  kidney  to 
the  left  iliac  fossa,  where  it  forms 
the— 
Sigmoid    Flexure    of  the    Colon,/ — 
curved  like  an/j  first  upwards,  then 
downwards;     extending    from    the 
crest  of  the  left  ileum  to  the  left 
sacro-iliac  synchondrosis. 
Rectum,-^ — from  the  last-named  point 
to  the  anus ;  is  6  to  8  inches  long, 
not    sacculated,    and,   though    not 
straight,  is  straighter  than  the  rest 
of  the   gut.     It  curves  laterally  to 
the  middle  of  the  sacrum,  and  back- 
wards  aboui  an  inch  above  its  ter- 
mination at  the  Anus,  i  where  it  is 
distended  into  a  pouch.     This  lower  inch  has  no  peritoneal  investment. 
Appendices  Epiploicce, — are  small  pouches  of  peritoneum  containing  fat,  and 
found  along  the  colon  and  part  of  the  rectum.     They  are  due  to  the  incom- 
pleteness of  the  investment  of  the  gut  by  peritoneum. 
Sphincters  of  the  Rectum  are  3,— the  sphincter  ani,  internal  sphincter  and 

sphincter  tertius  of  Hyrtl,     (See  ante,  pp.  83,  84.) 
Folds  of  Houston, — three  semilunar  transverse  folds,  one  in  the  upper  part  of 
the  rectum  on  the  right  side,  another  about  the  middle  on  the  left  side,  and 
the  third  in  front,  opposite  the  base  of  the  bladder. 

What  Glands  are  found  in  the  Large  Intestine  ?  The  Follicles  of 
Lieberkiihn  are  more  numerous  here  than  elsewhere,  also  a  few  Solitary 
Glands  and  Beyer's  Patches  in  its  upper  portion.  The  glands  of  Brunner 
are  absent,  the  villi  and  valvuise  conniventes  are  almost  wanting. 

State  the  Principal  Relations  of  each  of  the  three  parts  of  the 
Rectum.     They  are  as  follows,  viz. — 

Upper  Part  (4  inches), — lies  on  the  left  pyriformis  muscle  and  the  left 


THE   LIVER. 


153 


sacral  plexus ;  and  to  its  left  lie  the  left  ureter  and  branches  of  the  left 
internal  iliac  artery. 

Middle  Part  (3  inches),  in  the  male  subject  lies  just  behind  the  trigonum 
vesicae  and  the  vesiculie  seminales,  and  close  below  the  under  surface  of 
the  prostate  gland.  In  the  female  it  is  adherent  to  the  central  portion  of 
the  posterior  wall  of  the  vagina. 

Lower  Part  (i  inch), — is  surrounded  by  the  3  sphincters  and  the  levator 
ani  muscle,  and  is  separated  by  the  perineum  from  the  membranous  por- 
tion and  bulb  of  the  urethra  in  the  male,  from  the  vagina  in  the  female. 


THE  LIVER. 
Describe  the  Liver.  It  is  the  largest  gland  in  the  body,  weighing  from 
3  to  4  pounds,  measuring  transversely  about  12  inches,  antero-posteriorly  6 
inches,  in  greatest  thickness  3  inches.  It  is  situated  in  the  right  hypochon- 
driac, epigastric  and  part  of  the  left  hypochondriac  regions ;  has  5  fissures,  5 
lobes,  5  ligaments,  and  5  sets  of  vessels,  and  is  invested  by  peritoneum,  except 
for  a  small  space  at  the  attachment  of  the  coronary  ligament.  It  is  also  sur- 
rounded  by  a  fibrous  coat  which  is  continuous  at  the  transverse  fissure  with  the 
capsule  of  Glisson.     Its — 

Upper  Surface, — is  convex,  in  relation  with  the  under  surface  of  the  dia- 
phragm and  6  or  7  lower  ribs,  and  is  divided  into  two  lobes  by  the  sus- 
pensory or  broad  ligament. 
Under  Surface  (Fig.  73),  is  concave,  covers  the  stomach,  duodenum,  hepatic 
flexure  of  colon, 
right  kidney  and 
supra-renal  capsule, 
and  is  divided  into 
5  lobes  by  5  fissures. 
Anterior  Border yC — 
sharp  and  notched 
opposite  the  fundus 
of  the  gall-bladder 
and  the  round  and 
falciform  ligaments. 
It  corresponds  to  the 
lower  border  of  the 
ribs  and  costal  carti- 
lages, descending  a  little  lower  during  deep  inspiration  and  in  the  upright 
posture. 
Posterior  Border,^ — rounded,  and  deeply  grooved  ("sometimes  channeled) 
for  the  inferior  vena  cava.^'': 


154  VISCERAL  ANATOMY. 

Describe  the  5  Ligaments  of  the  Liver.  Four  are  folds  of  peritoneum  ; 
one,  the  round  ligament,  is  the  obliterated  umbilical  vein  and  ductus  venosus 
of  the  foetus.     The — 

Suspensory  or  Falciform  Ligament,j — called  also  the  Broad  and  the  Lon- 
gitudinal Ligament, — is  a  sickle-shaped  double  fold  reflected  over  the 
round  ligament,  and  is  attached  to  the  sheath  of  the  right  rectus  muscle 
as  low  as  the  umbilicus,  and  to  the  diaphragm. 

Coronary  Ligament,  ff^\%  a  double  fold,  containing  firm  areolar  tissue  in 
its  interspace,  and  extending  from  the  posterior  border  of  the  liver  to  the 
diaphragm. 

Lateral  LJgaments,  2, — are  the  triangular  extremities  of  the  coronary 
ligament. 

Round  Ligament,^ — ascends  in  the  free  margin  of  the  suspensory  ligament 
from  the  umbilicus  to  the  longitudinal  fissure,  in  which  it  is  continued  to 
the  vena  cava. 

Describe  the  5  Hepatic  Fissures.  They  are  all  situated  on  its  under 
surface,  and  separate  the  5  lobes,  one  from  another.     They  are  the — 

Longitudinal  Fissure,^ — its  anterior  two-thirds,  in  front  of  the  transverse 
fissure^  is  called  the  Umbilical  Fissure^  from  containing  the  umbilical 
vein  ;  its  posterior  one-third  is  the  Fissure  of  the  Ductus  Venosus,  lodg- 
ing the  slender  cord  which  represents  that  foetal  vessel. 

Transverse  Fissure,^ — about  2  inches  long,  running  from  the  longi- 
tudinal towards  the  right ;  and  transmit  the  portal  vein,  hepatic  artery, 
bile-duct,  lymphatics  and  nerves,  surrounded  by  the  Capsule  of  Glisson. 

Fissure  of  the  Gall  bladder,^ — on  the  right  of  the  longitudinal  fissure,  and 
nearly  parallel  with  it,  extending  from  the  anterior  border,  backwards  to 
near  the  right  end  of  the  transverse  fissure. 

fissure  for  the  Vena  Cava, — extends  inwards  from  the  posterior  border, 
where  it  joins  the  fissure  for  the  ductus  venosus;  and  gives  exit  to  the 
hepatic  veins  which  here  join  the  v6na  cava.  This  fissure  is  occasionally 
a  complete  foramen. 

Describe  the  5  Hepatic  Lobes.     Three  are  mere  lobules,  formed  from 
Ae  right  lobe  by  the  smaller  fissures.     The — 
Right  Lobe,a — is  much  the  largest,  and  presents  the  three  small  fissures 

and  two  depressions,  one  anteriorly  for  the   colon,  the   other  posteriorly 

for  the  kidney. 
Left  Lobe,i — is  divided  from  the  right  by  the  longitudinal  fissure,  and  rests 

upon  the  stomach. 
Z-obulus  Quadratus,^ — in  front  of  the  transverse  fissure,  and  between  the 

umbilical  fissure  and  that  for  the  gall  bladder. 


THE   LIVER. 


155 


Lobular  Plexus. 
(Fig-  74.) 


Lobtdus  Spigelii,y — behind  the  transverse  fissure,  and  between  the  fissure 

for  the  ductus  venosus  and  that  for  the  vena  cava. 
Lobtdus  CaudatuSyZ — a  connecting  ridge  from  the  lobulus  Spigelii  to  the 

right  lobe ;  it  separates  the  transverse  fissure  from  the  fissure  for  the  vena 

cava,  and  forms  the  roof  of  the  foramen  of  Winslow. 

Describe  the  5  Hepatic  Vessels.  They  are  the  —  portal  vein,^  hepatic 
artery ,f  hepatic  duct,/  and  lymphatics,  situated  in  the  transverse  fissure,  and 
surrounded  by  the  capsule  of  Glisson, — also  the  hepatic  veins  in  the  fissure 
for  the  vena  cava.     The — 

Portal  Vein,s — formed  by  the  superior  and  inferior  mesenteric,  splenic 
and  gastric  veins  (all  the  main  veins  of  the  abdomen  except  the  renal), 
is  about  4  inches  long.  It  enters  the  transverse  fissure  of  the  liver,  where 
it  divides  into  two  branches,  and  these  again  divide  and  subdivide  to 
ramify  throughout  the  gland.  Its  branches  are  the — 
Right  Portal.  Inter-lobular  Veins.  ^ 

Left  Portal.  Lobular  Veins. » 

Vaginal  Branches.  Intra-lobular  Veins.* 

Hepatic  Veins, — are  the  continuations  of  the  intra-lobular,  beginning  as  the 
Sub-lobular    Veins     beneath 
each  lobule,  and  entering  the 
inferior  vena  cava  in  the  fis- 
sure for  that  vessel. 
Hepatic  Artery,g — the  nutrient 
vessel   of   the   liver;    arises, 
from  the  coeliac  axis,  enters' 
the  transverse  fissure,  and  di- 
vides   into    branches   which 
supply  the  cellular  tissue,  the  ^. 
walls  of  the  vessels,  and  the 
investing  membranes  of  the 
liver,  also  forming  a  plexus  in 
each    lobule   which    anasto- 
moses    with     the     terminal 
branches  of  the  portal  vein. 
Hepatic  Duct, — about  i  ^  inch 
long ;  is  formed  in  the  trans- 
verse fissure  by  the  union  of 
the  two  main  biliary  ducts,  from  the  right  and  left  lobes.     It  joins  the 
cystic  duct  from  the  gall-bladder  to  form  the  Ductus  Communis  Chol6do- 
chus.     (See  next  page.) 


156 


VISCERAL  A^fATOMY. 


Lymphatics, — accompany  the  blood  vessels  in  two  sets,  a  superficial  set  anH 

a  deep  one. 
What   Nerves  supply  the  Liver?     Branches  of  the  Hepatic  Plexus, 
which  is  formed  by  branches  derived  from  the  left  pneumogastric,  right  phrenic 
and  solar  plexus. 

Describe  the  Structure  of  the  Liver.     The  substance  of  the  liver  is 

composed  of  numerous 
Lobules,'^  of  polygonal 
shape,  and  about  -^-^  of 
an  inch  in  diameter,  clus- 
tered around  the  sub- 
lobular  branches  of  the 
hepatic  veins,  and  con- 
nected together  by  con- 
nective tissue, 3  blood 
vessels,  ducts, ^  and  lym- 
phatics. Each  lobule 
consists  of — 

Hepatic    Cells,  —  each 
about  the  j^^^^  of  an 
inch     in     diameter, 
having  a  nucleus  and 
nucleolus,  yellow  coloring  matter,  glycogen  granules,  and  oil  globules. 
Lobular  Veins, ^ — forming  a  plexus  in  the  lobule.      1  ,  . 

Intra-lobular  Vein,^ — in  the  centre  of  each  lobule,  j 
Plexuses, — of  lymphatics,  nerves,  and  bile-ducts. 

What  is  the  Capsule  of  Glisson  ?  The  areolar  tissue  which  surrounds 
the  hepatic  vessels  in  the  transverse  fissure,  and  accompanies  them  in  their 
course  throughout  the  substance  of  the  liver.  It  is  continuous  with  the  fibrous 
covering  of  the  organ. 

How  may  the  Portal  Veins  be  distinguished  from  the  Hepatic,  on 
section  of  the  Liver  ?  The  portal  veins  remain  closed,  being  surrounded 
by  the  capsule  of  Glisson.  The  hepatic  veins  gape  open,  being  adherent  to 
the  liver  substance. 

Describe  the  Gall-bladder.  It  is  a  pear-shaped  bag,  3  to  4  inches 
long,  an  inch  in  greatest  diameter,  holding  from  8  to  12  fluid  drachms, 
invested  by  peritoneum  on  its  under  surface  and  fundus,  formed  of  a  fibro- 
muscular  coat  and  lined  by  a  mucous  one,  lying  in  a  fissure  on  the  undei 
surface  of  the  liver,  dose  to  its  anterior  border,  and  directed  obliquely  down- 
wards, forwards,  and  to  the  right.     Its — 


THE  PANCREAS.  157 

Fundus, — touches  the  abdominal  wall   immediately  below  the    9th  costal 

cartilage,  and  is  completely  invested  by  peritoneum. 
Neck, — coils  twice  upon  itself,  and  empties  into  the  Cystic  Duct,  which  is 

about  an  inch  long,  and  joins  with  the  Hepatic  Duct  to  form  the  Ductus 

Communis  Chol6dochus. 

What  is  the  Ductus  Communis  Choledochus  ?  A  fibro- muscular  tube, 
covered  by  peritoneum  and  lined  with  mucous  membrane,  about  3  inches  in 
length,  formed  by  the  junction  of  the  Cystic  and  Hepatic  ducts,  and  emptying 
its  contents  (bile)  into  the  descending  part  of  the  duodenum  at  a  point  about 
3  inches  from  the  pyloric  orifice  of  the  stomach,  generally  in  common  with 
the  duct  of  the  pancreas.  The  three  ducts  above-named  are  often  called  the 
Biliary  Ducts. 

THE  PANCREAS. 
Describe  the  Pancreas.  The  Pancreas  is  a  racemose  gland,  about  7 
inches  long,  of  a  grayish-white  color,  situated  behind  the  stomach  and  in  front 
of  the  first  lumbar  vertebra.  Its  structure  resembles  that  of  the  salivary 
glands,  being  composed  of  reddish-yellow  lobules,  united  by  cellular  tissue, 
vessels  and  ducts,  and  ending  in  closed  pouches  surrounded  by  a  capillary 
plexus.     The — 

Pancreatic  Duct,  or  Duct  of  Wirsung,  ^ — extends  the  whole  length  of  the 
gland,  and  opens  into  the  P^^    g 

duodenum  about  3  inches 
below  the  pylorus,  by  an 
orifice  common  to  it  and 
the  ductus  communis  chole- 
dochus. 
Head,  or  Right  Extremity,  ^  I 

is  surrounded  by  the  curve  of  the  duodenum,  the  ductus  communis  chole- 
dochus and  the  pancreatico-duodenal  arteries. 
Tail,  or  Left  Extremity,  * — lies  above  the  left  kidney  and  in  contact  with 

the  lower  end  of  the  spleen. 
Body  3— is  in  relation  anteriorly  with  the  ascending  layer  of  the  transverse 
mesocolon,  the  posterior  wall  of  the  stomach  and  the  transverse  colon  ■ 
posteriorly  with  the  aorta,  portal  vein,  inferior  vena  cava,  splenic  vein, 
origin  of  the  superior  mesenteric  artery,  crura  of  the  diaphragm,  left  kid- 
ney and  supra-renal  capsule,  and  the  left  quadratus  lumborum  muscle. 
Arteries,  are  the — 

Pancreatica  Magna,  and  Pancreaticae  Parvae,  from  the  splenic. 

Pancreatico-duodenalis, — branch  of  the  hepatic  artery. 

Inferior  Pancreatico-duodenalis, — branch  of  the  sup.  mesenteric. 


158  VISCERAL  ANATOMY. 

Veins, — open  into  the  splenic  and  mesenteric  veins. 

Nerves, — from  the  solar  plexus,  forming  a  Splenic  Plexus. 

What  is  the  Lesser  Pancreas  ?  A  lobe  of  the  head  of  the  pancreas; 
sometimes  detached  therefrom,  in  which  case  it  opens  by  a  duct  into  the 
duodenum  about  an  inch  above  the  orifice  of  the  pancreatic  duct. 

THE  DUCTLESS  GLANDS. 
Name  the  so-called  Ductless  Glands.  They  are  the  Spleen,  Supra- 
renal Capsules,  Thyroid  and  Thymus  Glands.  The  first  two  are  in  the  abdo- 
minal cavity,  the  thyroid  gland  is  in  the  front  of  the  trachea,  and  the  thymus 
gland  is  in  the  anterior  mediastinum  of  the  thorax.  These  organs  have  no 
excretory  ducts,  and  their  functions  are  unknown. 

THE  SPLEEN. 
Describe  the  Spleen.     The  spleen  is  a  soft,  spongy  and  very  vascular 
organ,  about  5  by  3  by  2  inches,  from  6  to  10  ounces  in  weight,  and  situated 
deeply  in  the  left  hypochondrium,  embracing  the  cardiac  end  of  the  stomach, 
to  which  it  is  connected  by  the  gastro- splenic  omentum.     Its — 

Outer  Surface,— Ss,  convex,  corresponds  to  the  9th,  loth  and    nth  ribs, 
and  is  in  relation  with  the   inferior  surface  of  the 
diaphragm. 
Inner  Surface, — is  concave,  and  embraces  the  cardiac 

or  splenic  end  of  the  stomach. 
Borders, — the  anterior  is  thin  and  often  notched ;  the 

posterior  is  thick  and  lies  on  the  left  kidney. 
Suspensory  Ligament, — attaches  the  upper  extremity  to 

the  diaphragm,  and  is  a  fold  of  peritoneum. 
Hilum, — a  vertical  fissure  about  the  middle  of  the  con- 
cave surface .     It  is  pierced  by  the  vessels,  lymphatics 
and  nerves. 

Peritoneal,  or  Serous  Coat, — covers  the  whole  organ,  except  at  the  attach- 
ments of  the  suspensory  ligaments  and  the  gastro- splenic  omentum, 
Fibro-elastic  Coat,  or  Tunica  Propria, — is  reflected  at  the  hilum  upon  the 
vessels,  and  gives  off  numerous  bands  [trabeculce'),  which  bound  the 
lacunar  spaces  [areolce)  of  the  organ. 
Malpighian  Corpuscles, — are  lymphoid  sphenoidal  expansions  of  the 
outer  coat  of  the  small  arteries,  and  average  in  diameter  about  the  -^^ 
of  an  inch.  They  are  attached  to  the  arterioles  of  the  organ  in  groups 
of  6  or  8,  and  are  usually  pierced  by  an  artery.  Their  reticulum  is  slender 
and  open,  densely  filled  with  lymphoid  corpuscles,  and  well  supplied 
with  capillaries.     They  have  no  capsule. 


THE  THYROID  GLAND.  159 

Splenic  Substance  or  Pulp, — a  soft,  pulpy,  brown-red  mass,  surrounding  the 
Malpighian  corpuscles,  and  contained  in  the  areolae.  It  consists  of  a 
delicate  net-work  of  connective-tissue  corpuscles,  containing  pigment- 
granules  (disintegrated  blood-corpuscles),  granular  albuminous  matter, 
nucleated  and  non-nucleated  cells,  and  free  nuclei,  also  red  blood- 
corpuscles  in  every  stage  of  metamorphosis.  These  are  denominated 
the  colored  and  colorless  elements. 

Splenic  Artery, — is  large  and  tortuous,  and  divides  at  the  hilum  into  5  or  6 
branches,  each  supplying  a  segment  of  the  organ,  and  terminating  either 
directly  in  the  venous  radicles,  or  in  the  lacunar  spaces. 

Splenic  Vein, — arises  by  radicles  partly  from  the  capillaries,  partly  from  the 
lacunar  spaces,  and  empties  into  the  portal  vein. 

Nerves, — are  derived  from  the  semi-lunar  ganglion  of  the  solar  plexus  and 
the  right  pneumogastric,  forming  the  Splenic  Plexus. 

THE  THYROID  GLAND. 

Describe  the  Thyroid  Gland.     It  is  a  bi-lobed  organ,  about  3  inches  in 
length,  situated  on  the  sides  of  the  upper  2  or  3  rings  of  the  trachea,  and  con- 
sisting of  minute  closed  vesicles  containing  a  yellow-colored  fluid,  surrounded  by 
a  dense  plexus  of  capillaries,  and  connected  together  by  areolar  tissue.     Its — 
Isthmus, — connects  the  lower  third  of  each  lobe  together,  passing  in  front 

of  the  trachea.     It  is  occasionally  absent. 
Pyrafuid, — is  a  third  lobe,  which  sometimes  arises  from  the  left  lobe,  or 

from  the  left  upper  border  of  the  isthmus. 
Levator    Glandules    Thyroidece, — are   muscular  bands   occasionally  found 
extending  from  the  body  of  the  hyoid  bone  to  the  isthmus  of  the  gland  or 
its  pyramid. 

Name  the  Arteries  of  the  Thyroid  Gland.     They  are  very  large,  anas- 
tomose freely,  and  are  the — 

Superior  Thyroid, — branch  of  the  external  carotid,  arising  therefrom  below 
the  greater  cornu  of  the  hyoid  bone,  and  giving  off  the  following  branches^ 
viz. — 

Muscular.         Hyoid.  Superior  Laryngeal. 

Glandular.        Superficial  Descending.  Crico-thyroid. 

Middle    Thyroid,  Artery  of  Neubauer^   or  Arteria    Thyroidea    ImUy — ig 
occasionally  found  arising  from  the  innominate  artery  or  directly  from 
the  arch  of  the  aorta,  passing  upwards  along  the  front  of  the  trachea. 
Inferior  Thyroid,  branch  of  the  thyroid  axis,  gives  off — 

Laryngeal  Branch.  (Esophageal  Branches. 

Tracheal  Branches.  Ascending  Cervical. 


160  VISCERAL  ANATOMY. 

Enumerate  the  Veins  and  Nerves  of  the  Thyroid  Gland.  The 
Veins  form  a  plexus  in  front  of  the  gland  and  the  trachea,  giving  rise  to  the — 

Superior  Thyroid  Vein.    i  ,         ,     ^  ,  ^       •,      ,.  . 

Middle  Thyroid  Vein.        I  °P'"  '"'°  "^^  ^"'''"'''  J'S"'"'  ^''"- 

Inferior  Thyroid  Vein,  opens  into  the  Innominate  Vein. 
Nerves — are    branches    of    the   pneumogastric,  and   of   the    middle    and 

inferior  ganglia  of  the  sympathetic. 

THE  THYMUS  GLAND. 

What  is  the  Thymus  Gland  7  It  is  a  temporary  organ,  attaining  its 
full  size  about  the  age  of  2  years,  then  being  about  2  inches  long,  ij4.  inch 
broad,  3  lines  thick,  and  weighing  about  half  an  ounce.  It  subsequently 
atrophies,  and  has  almost  disappeared  at  puberty.  It  is  situated  in  the  anterior 
mediastinum  and  the  neck,  behind  the  sternum  and  the  sterno-hyoid  and 
sterno-thyroid  muscles,  extending  from  the  level  of  the  4th  costal  cartilage  to 
the  lower  border  of  the  thyroid  gland.  In  the  mediastinum  it  rests  upon  the 
pericardium,  and  is  separated  by  the  thoracic  fascia  from  the  arch  of  the  aorta 
and  the  great  vessels. 

Describe  its  Structure.  The  Thymus  gland  consists  of  two  lateral  lobes 
(sometimes  a  third),  together  forming  a  pyramidal  mass.  It  is  surrounded  by 
a  (ibrous  capsule  and  is  divided  by  Trabecules  into  primary  and  secondary 
lobules,  which  consist  of  meshes  of  delicate  retiform  tissue  closely  packed 
with  lymph-corpuscles,  and  pervaded  with  capillaries.  The  so-called  Central 
Cavity  and  Primitive  Linear  Tube,  are  deceptive  appearances  of  the  multi- 
plying cells  in  the  interior  of  the  gland. 

Name  its  Vessels  and  Nerves.     The  Thymus — 
Arteries, — are   derived   from  the  internal   mammary,  superior   and   inferior 

thyroid,  subclavian  and  carotid.     They  ramify  on  the  surface  of  each  lobule, 

having  smaller  twigs  converging  toward  the  centre. 
Veins,— open  into  the  left  innominate  and  the  thyroid. 
Lymphatics, — consist  of  intralobular  and  interlobular  plexuses,  and  open  into 

the  anterior  mediastinal  glands. 
Nerves, — are  very  minute  and  derived  from  the  pneumogastric  and  the  sym- 
pathetic. 

THE  SUPRA-RENAL  CAPSULES. 

What  are  the  Supra^Renal  Capsules  ?  They  are  two  small,  crescentic 
shaped  bodies,  situated  one  on  each  kidney.  Each  presents  a  small  fissure  or 
Hilum  anteriorly,  from  which  its  vein  emerges,  and  consists  of  a — 

Fibrous  Capsule, — which  is  very  thin,  closely  adherent,  and  sends  numerous 
septa  inwards. 


Tttfe  ABDOMINAL  CAVITY.  16l 

Cortical  Substance, — composed  of  columnar  and  rounded  cells,  held  together 

in  layers  by  a  fibrous  stroma. 
Medullary  Substance,— \s   darker  than   the   cortical   portion,   and  pulpy. 

Consists  of  cells  in  groups,  supported  by  a  delicate  stroma,  and  believed 

by  some  anatomists  to  be  prolonged  into  nerve  fibres. 

What  are  their  Relations  ?  Their  bases  rest  on  the  upper  front  parts  of 
the  kidneys,  their  posterior  surfaces  on  the  crura  of  the  diaphragm,  about  the 
level  of  the  loth  dorsal  vertebra.     The — 

Anterior  Surface, — of  the  right  capsule  is  covered  by  the  liver;  that  of  the 

left  one  by  the  spleen  and  pancreas, 
Superior  Surface, — of  each  is  in  relation  internally  with  the  great  splanchnic 
nerve  and  semilunar  ganglion. 

Name  their  Vessels  and  Nerves.  The  Lymphatics  of  these  bodies 
open  into  the  lumbar  glands,  but  are  very  imperfectly  known.     Their — 

Arteries, — are  the  Supra-renal  Branches  of  the  aorta,  renal,  and  inferior 
phrenic  arteries,  forming  a  dense  capillary  plexus  in  the  cortical  portion 
of  the  organ. 

Veins, — of  each  open  into  a  single  trunk,  the  Supra-renal  Vein,  which  on 
the  right  side  of  the  body  empties  into  the  inferior  vena  cava,  on  the  left 
side  into  the  left  renal  vein. 

Nerves, — are  chiefly  derived  from  the  solar  and  renal  plexuses,  with  some 
filaments  from  the  phrenic  and  pneumogastric  nerves,  forming  a  compli- 
cated network  in  the  medullary  substance  of  the  organ,  and  having 
numerous  small  ganglia  developed  upon  them. 

THE  ABDOMINAL  CAVITY. 

What  is  the  Abdomen  ?  An  oval  cavity,  situated  between  the  thorax 
above  and  the  pelvis  below,  invested  by  peritoneum  internally,  and  containing 
the — 

Stomach.  Pancreas.  Abdominal  Aorta. 

Intestines.  Kidneys  and  Ureters.  Inferior  Vena  Cava. 

Liver.  Supra-renal  Capsules.  Receptaculum  Chyli. 

Gall-bladder.  Bladder  (when  distended.)      Thoracic  Duct. 

Spleen.  Uterus  (during  pregnancy.)     Solar  Plexus,  etc. 

Name  the  Boundaries  of  the  Abdomen.  Above,  it  is  bounded  by  the 
diaphragm; — below,  by  the  brim  of  the  -^^i-^'vi',— posteriorly,  by  the  vertebral 
column,  and  the  fasciae  covering  the  psose  and  quadrati  luvnborum  muscles ; — 
anteriorly  and  laterally,  by  the  transversalis  fascia,  the  lower  ribs,  and  the 
venter  of  the  ilium, 
K 


162 


VISCERAL  ANATOMY. 


What  Openings  are  found  in  its  Walls  ?     They  are  the — 
Opening for'the  Vena  Cava,—  in  the  diaphragm. 
Aortic  Openings — behind  the  diaphragm,  for  the  aorta,  vena  azygos  minor,  the 

thoracic  duct,  and  occasionally  the  left  sympathetic  nerve. 
(Esophageal  Opening, — in  the  diaphragm,  for  the  oesophagus,  and  the  pneumo- 

gastric  nerves. 
Umbilical  Opening, — in  the  anterior  wall,  transmitting  the  umbilical  vessels  in 

the  foetus,  but  obliterated  after  birth,  leaving  a  puckered  depression,  the 

Umbilicus. 
Internal  Abdominal  Ring, — on  each  side,  half  an  inch  above  Poupart's  liga- 
ment, for  the  passage  of  the  spermatic  cord  in  the  male,  and  the  round 

ligament  of  the  uterus  in  the  female. 
Femoral  or  Crural  Ring, — on  each  side,  just  below  Poupart's  ligament;   for 

the  passage  of  the  femoral  vessels.     This  opening  is  closed  by  the  Septum 

Crurale.     (See  Femoral  Hernia.) 

Name  the  Regions  of  the  Abdomen.  The  Abdomen  is  divided  into  9 
regions,  by  two  horizontal  lines, — one  between  the  cartilages  of  the  9th  ribs, 
another  between  the  crests  of  the  ilia, — and  2  vertical  lines  from  the  cartilages 
of  the  8th  ribs  to  the  centre  of  Poupart's  ligament.  The  9  regions  thus  formed 
are  named  the — 

Epigastric. 
Umbilical. 
Hypogastric. 

What  Parts 
Region  "> 
Right    Hypochondriac    Region,- 

the  right  lobe  of  the  liver,  gall-bladder, 
duodenum,  hepatic  flexure  of  the  colon, 
upper  part  of  the  right  kidney,  and  the 
right  supra-renal  capsule. 
Epigastric  Region, — contains  the  right 
two-thirds  of  the  stomach,  left  lobe  and 
lobus  Spigelii  of  the  liver,  hepatic 
vessels,  coeliac  axis,  solar  plexus,  pan- 
creas, and  parts  of  the  aorta,  inferior  vena 
cava,  vena  azygos,  and  thoracic  duct. 
\Left  Hypochondriac  Region, — contains  the 
splenic  end  of  the  stomach,  spleen,  tail 
of  the  pancreas,  splenic  flexure  of  the 
colon,  upper  half  of  the  left  kidney  and 
its  supra-renal  capsule. 


Right  Hypochondriac. 
Right  Lumbar. 
Right  Inguinal, 
Fig.  78. 


Left  Hypochondriac. 

Left  Lumbar. 

Left  Inguinal. 

are  contained  in  each 


;ontams 


THE  PERITONEUM.  163 

Right  Lumbar  Region, — contains  the  ascending  colon,  lower  half  of  the  right 

kidney,  and  part  of  the  small  intestine. 
Umbilical^ — contains  the  transverse  colon,  transverse  duodenum,  part  of  the 

great  omentum  and  mesentery,  and  part  of  the  small  intestine. 
Left  Lumbar  Region, — contains  the  descending  colon,  low^er  half  of  the  left 

kidney,  and  part  of  the  small  intestine. 
Right  Inguinal  Region, — contains  the  right  ureter,  caecum,  appendix  vermi 

formis,  and  the  spermatic  vessels  of  that  side. 
Hypogastric  Region, — contains   part   of  the   small  intestine,  the  bladder  in 

children  and  vi'hen  distended  in  adults,  and  the  uterus  during  pregnancy. 
Left  Inguinal  Region, — contains  the  left  ureter  and  spermatic  vessels,  and  the 

sigmoid  flexure  of  the  colon. 

THE  PERITONEUM. 

What  is  the  Peritoneum  ?  A  serous  membrane,  forming  a  closed  sac, 
\\s, parietal  layer  lining  the  v^^alls  of  the  abdomen  and  pelvis,  its  visceral  layer 
being  reflected  more  or  less  completely  over  all  the  abdominal  and  pelvic 
viscera.  Its  free  surface  is  covered  with  squamous  epithelium,  and  is  smooth, 
moist,  and  shining  Its  attached  surface  is  connected  to  the  viscera  and  the 
parietes  of  the  abdomen  by  the  sub-peritoneal  areolar  tissue. 

Is  the  Peritoneum  always  a  closed  sac  ?  No  !  In  the  female  it  is  con- 
tinuous with  the  mucous  lining  of  the  Fallopian  tubes,  which  at  their  free 
extremities  open  into  its  cavity. 

Name  the  Divisions  of  the  Peritoneum.     The — 
Greater  Sac^ — extends  over  the  anterior  two-thirds  of  the  liver,  behind  and 

above  the  stomach,  below,  behind,  and  in  front  of  the  great  omentum,  and 

below  the  meso-colon. 
Lesser  Sac,  or  Cavity  of  the  Great  Omentum, —  extends  behind  and  below  the 

liver  and  stomach,  above  the  meso-colon,  and  within  the  great  omentum. 

What  is  the  Foramen  of  Winslow  ?  A  constriction  of  the  peritoneal 
cavity  connecting  the  two  sacs,  situated  behind  the  right  free  border  of  the  gastro- 
hepatic  or  lesser  omentum,  and  formed  by  the  gastric  and  hepatic  arteries  as 
they  curve  around  to  the  coeliac  axis.     Its  boundaries  are  as  follows,  viz. — - 

Anteriorly, — the  lesser  omentum,  containing  the  duodenum,  hepatic  artery, 
portal  vein,  and  the  ductus  communis  choledochus. 

Posteriorly, — the  inferior  vena  cava,  and  the  right  crus  of  the  diaphragm. 

Superiorly, — the  lobus  SpigSlii  of  the  liver. 

Inferiorly, — the  hepatic  artery,  curving  forwards  from  the  coeliac  axis 

What  passes  through  the  Foramen  of  Winslow .'     Nothing. 


164 


VISCERAL  ANATOMY. 


Fig.  79. 


What  are  the  Omenta  or  Epiploa  ?     They  are  folds  of  peritoneum  con. 
necting  the  stomach  with  other  organs,  and  are  3  in  number,  namely,  the — 
G astro- colic  or  Great  Omentum,^  ^ — consists  of  four  layers  of  peritoneum, 

the  most  anterior  and  posterior  of  which 
belong  to  the  greater  sac,  the  two  inter- 
nal to  the  lesser  sac.     The  two  anterior 
layers  descend  from  the  stomach  and  the 
spleen,  over   the   small   intestines,  and 
then  ascend  as  the  posterior  layers,  to 
enclose  the  transverse  colon. 
Gastro- hepatic  or  Lesser  Omentum, — con- 
sists of  two  layers  of  peritoneum,  the 
upper  belonging  to  the  greater  sac,  the 
lower  to  the  lesser  sac.     It  extends  from 
the  transverse  fissure  of  the  liver  to  the 
lesser  curvature  of  the  stomach,  and  con- 
tains in  its  right  free  margin  the — 
Hepatic  Artery. 
Portal  Vein. 
Lymphatics. 

Ductus  Communis  Chol6dochus. 
First  part  of  the  Duodenum. 
Hepatic  Plexus  of  Nerves. 
Gastro- splenic     Omentum, — connects    the 
•    stomach  with  the  spleen,  and  is  con- 
tinuous  by  its  lower  border   with   the 
great  omentum.     It  contains  the  Splenic 
Vessels  and  the  Vasa  Brevia. 
What  are  the  Mesos  or  Mesenteries  ?     Folds  of  peritoneum  connect- 
ing the  various  parts  of  the  intestinal   canal  (except  the  duodenum)  to  the 
abdominal  walls.     Each  one  contains  the  vessels  of  the  part  which  it  sup- 
ports.    They  are  the — 

Mesentery  proper. ^^       Meso-ccecum.       Meso-colon.^^       Meso-rectum. 
What  Ligaments  are  formed  by  the  Peritoneum  ?     They  are  17  folds 
of  peritoneum  which  support  certain  organs,  viz. — 

I    G astro-phrenic, — from  the  stomach  to  the  diaphragm. 

4  Hepatic — the  longitudinal,  coronary,  and  2  lateral  ligaments  of  the  hver. 

5  Vesical, — the  false  ligaments  of  the  bladder. 

6  Uterine, — 2  vesico-uterine,  2  recto-uterine,  and  2  lateral  or  broad  liga- 
ments of  the  uterus. 

I  Splenic, — the  suspensory  ligament  of  the  spleen. 


THE  LARYNX.  166 

Name  the  Viscera  covered  by  Peritoneum.     They  are  the — 
Liver^  (almost  wholly).  Transverse  Colon.^ 

Stomach"^  (almost  wholly).  Sigmoid  Flexure. 

Spleen.  Rectum  (upper  y^). 

Duodenum^  (first  part).  Ovaries. 

Small  Intestine.^  Uterus.^ 

Name  the  Viscera  partially  invested  by  Peritoneum.     The — 

Duodenum^  (descending  and  Descending  Colon. 

transverse  portions).  Rectum'^  (middle  third). 

Ccecum.  Vagina^  (upper  part). 

Ascending  Colon.  Bladder^'^  (posterior  wall). 

What  Viscera  have  no  Peritoneal  Investment  ?     The — 

Rectum''  (lower  third).  Pancreas.^ 

Bladder"^  o  (neck,  base  and  Kidneys. 

anterior  surface).  Supra-renal  Capsules. 

Vagina^  (lower  part). 

What  are  the  Appendices  Epiploicae  ?  Pouches  of  peritoneum  situated 
along  the  colon  and  upper  third  of  the  rectum,  and  filled  with  fat.  They  are 
chiefly  found  along  the  transverse  colon. 

A  Demonstration  of  the  Peritoneum  is  best  made  with  a  large  bag  of 
mosquito- netting,  sewn  up  along  all  four  sides,  and  having  a  central  slit  to 
represent  the  incision  usually  made  in  the  laparotomy  operation.  Sponges  of 
various  sizes  will  represent  the  various  organs,  and  may  be  pushed  into  folds 
of  the  bag  and  tied  in  by  string,  wholly  covered  or  partially  covered,  as  the 
<ase  may  be,  for  each.  Professor  Pancoast  used  this  method  of  demonstration 
in  his  lectures,  making  the  subject  perfectly  clear  to  many  who  never  under- 
stood it  before. 

ORGANS  OF  VOICE  AND  RESPIRATION. 
THE  LARYNX. 

What  is  the  Larynx  ?  A  musculo-membranous-cartilaginous  box  placed 
between  the  trachea  and  the  base  of  the  tongue,  and  constituting  the  essential 
organ  of  voice. 

Name  its  Cartilages.  They  are  nine  in  number,  3  single  and  3  in  pairs, 
viz. — 

Thyroid  Cartilage.  2  Arytenoid  Cartilages. 

Cricoid  Cartilage.  2  Cuneiform  Cartilages. 

Epiglottis.  2  Cornicula  Laryngis. 


166  VISCERAL  ANATOMY. 

Describe  the  Thyroid  Cartilage.     The  Thyroid  or  shield  like  cartilage 

consists  of  two  Ala;  or  wings/  united  in  front  at  an  acute  angle,  the  highest 

portion  of  its  front  being  called  the  Pomum  Adarni,  Adam's  apple.     Its — 

Inner  Surface, — gives  attachment   to  the  true  and  false  vocal  cords,  the 

epiglottis,  thyro-arytenoid  and  thyro-epiglottidean  muscles,  and  the  thyro- 

Pjj,  8o  epiglottic  ligament. 

Outer  Surface, — affords  attachment  to  the  sterno- 
thyroid, thyro-hyoid  and  inferior  constrictor  mus- 
cles ;  the  first  two  being  attached  along  its  oblique 
ridge. 
Upper  Border, — is  curved  irregularly,  and  gives  at- 
tachment to  the  thyro-hyoid  membrane. 
Lower  Border, — gives  attachment   to   the  cricothyroid  membrane  in  the 

median  line  and  on  each  side  to  the  crico-thyroid  muscle. 
Posterior  Border  oi  each  wing  ends  above   and  below  in   Cornua  (horns), 

and  gives  attachment  to  the  stylo-  and  palato-pharyngeus  muscles. 
Superior  Cornu  of  each  side  affords  attachment  to  the  thyro-hyoid  ligament. 
Inferior  Cornu  of  each  side  articulates  with  the  cricoid  cartilage  by  a  small 
oval  facet.     (See  «  and  ^,  Fig.  80.) 

Describe  the  Cricoid  Cartilage.     The  Cricoid,  or  ring-like  cartilage,  is 
Fig.  81.  placed  below  the    thyroid,  with    its    narrow   part    to    the 

front.  It  has  on  each  side  2  Articular  Facets,  one  on  the 
upper  margin  posteriorly  for  the  arytenoid  cartilage,  and 
one  near  the  lower  margin  for  the  inferior  cornu  of  the 
thyroid  cartilage.     Its — 

Outer  Borders, — give  attachment  to  the  crico-arytenoideus 
posticus  muscle,  and  the  longitudinal  fibres  of  the  oesophagus. 
Upper  Border, — affords  attachment  to  the  crico-thjrroid  membrane  and  the 

crico-arytenoidei  laterales  muscles. 
Lower  Border, — is  connected  to  the  upper  ring  of  the  trachea  by  fibrous 
membrane. 

Describe  the  Arytenoid  Cartilages.  The  Arytenoid,  or  pitcher  like 
cartilages,  are  2  in  number,  pyramidal -shaped,  and  situated  on  the  upper  mar- 
gin of  the  cricoid  cartilage  posteriorly,  closing  in  the  back  of  the  larynx. 
Each  cartilage  has  3  surfaces,  2  angles,  a  base  and  an  apex.     The — 

Anterior   Surface, — gives   attachment   to   the    false   vocal 
Fig.  82.  chord,  and  the  thyro-arytenoideus  muscle. 

Anterior  Angle, — gives  attachment  to  the  true  vocal  chord 

and  the  thyro-arytenoideus  muscle. 
Posterior  Surface, — has  attached  to  it  the  arytenoideus. 


^ 


THE  LARYNX.  167 

Posterior  Angle, — gives  attachment  to  the  crico-arytenoideus  lateralis  and 

posticus  muscles. 
Internal  Surfaces  of  each  look  towards  each  other. 
Base, — has  a  facet  for  articulation  with  the  cricoid. 
Apex, — articulates  with  the  corniculum  laryngis. 

What  are  the  Cornicula  Laryngis  ?  They  are  2  small  cartilaginous 
nodules  attached  to  the  apices  of  the  arytenoid  cartilages,  and  are  also  called  the 
Cartilages  of  Santorini.  To  them  are  attached  the  aryteno-epiglottidean  folds. 
What  are  the  Cuneiform  Cartilages  ?  The  Cuneiform,  or  Cartilages  of 
Wrisberg,  are  2  rods  of  yellow  elastic  cartilage  contained  in  the  free  bor- 
ders of  the  aryteno-epiglottidean  folds. 

Describe  the  Epiglottis.  The  Epiglottis  is  a  cartilaginous  lid  for  the 
larynx.  It  is  leaf-shaped,  situated  behind  the  base  of  the  tongue,  and  attached 
by  its  apex  to  the  posterior  surface  of  the  thyroid  cartilage,  just  below  the 
median  notch.     Its — 

Base, — is  free,  and  curves  over  the  base  of  the  tongue. 

Apex, — is  connected  to  the  receding  angle  of  the  thyroid  cartilage  by  the 

thyro-epiglottidean  ligament. 
Anterior  Surface, — is  attached  to  the  hyoid  bone  by  the  hyo- epiglottic  liga- 
ment, and  to  the  tongue  by  3  glosso-epiglottidean  folds. 
Posterior  Surface, — covers  the  superior  aperture  of  the  larynx  when  food 

passes  through  the  pharynx. 
Lateral  Margins, — are  connected  to  the  arytenoid  cartilages  by  the  aryteno- 
epiglottidean  folds. 
Name  the  Ligaments  of  the  Larynx.     They  are  19  in  number, — 3  ex- 
trinsic ligaments,  connecting  the  larynx  to  the  hyoid  bone;   and  16  intrinsic, 
binding  its  several  cartilages  together,  viz. — 
Extrinsic  Ligaments  (3),  are  the — 

Thyro-hyoid  Membrane,  bounded  laterally  by — 

2  Lateral  Thyro-hyoid  Ligaments,  each  contain  a  nodule  of  cartilage, 
the  Car  til  ago  Triticea. 
Intrinsic  Ligaments  (16)  are  the — 
Crico-thyroid  Membrane. 
2  Crico-thyroid  Capsular  Ligaments. 
2  Crico- arytenoid  Ligaments. 
2  Crico- arytenoid  Capsular  Ligaments. 
2  Superior  Thyro-arytenoid  (situated  in  the  false  vocal  chords). 

2  Inferior  Thyro-arytenoid  (situated  in  the  true  vocal  chords). 
Hyo- epiglottic  Ligament. 

Thyro-epiglottic  Ligament. 

3  Glosso- epiglottic  Folds. 


168  VISCERAL  ANATOMY. 

Describe  the  Vocal  Chords.  They  are  in  two  sets,  the — 
Superior  or  False  Vocal  Chords^ — containing  the  superior  thyro- arytenoid 
ligaments, — extend  from  the  angle  of  the  thyroid  cartilage  around  to  the 
anterior  surfaces  of  the  arytenoids,  and  consist  of  two  folds  of  mucous  mem- 
brane, each  having  a  free  crescentic  margin. 
Inferior  or  True  Vocal  Chords, — containing  the  inferior  thyro- arytenoid  liga- 
ments,— extend  from  the  angle  of  the  thyroid  cartilage  around  to  the  ante- 
rior angles  of  the  bases  of  the  arytenoids,  and  consist  of  two  thin  layers  of 
mucous  membrane  covering  the  ligaments  named,  each  having  the  thyro- 
arytenoideus  muscle  external  and  parallel  to  it. 

What  is  the  Glottis  ?  The  Glottis  or  Rima  Glottidis  is  a  narrow  chink 
or  interval  between  the  inferior  vocal  chords,  formed  by  the  projection  into 
the  cavity  of  the  larynx  of  these  chords  and  the  thyro- arytenoidei  muscles. 
Its  greatest  length  is  less  than  an  inch,  its  greatest  breadth  about  half  an  inch. 
Its  form  is  a  narrow  fissure  of  varying  size. 

What  is  the  Ventricle  of  the  Larynx  ?  An  oval  depression  on  each 
side  of  the  larynx,  between  the  true  and  false  vocal  chords,  leading  up  to  the 
sacculus  laryngis  by  a  narrow  opening. 

What  is  the  Sacculus  Laryngis  ?  A  blind  pouch  situated  in  each 
laryngeal  wall  at  the  level  of  the  false  vocal  chord.  It  is  of  conical  shape, 
and  contains  60  or  70  small  mucous  glands  which  secrete  a  fluid  for  the 
lubrication  of  the  true  vocal  chord.  The  sacculus  is  covered  in  by  the 
aryteno-epiglottideus  inferior  muscle  internally,  and  by  the  thyro -epiglot- 
tideus  externally,  both  muscles  compressing  it  to  discharge  its  contents.  The 
Sacculus  Laryngis  is  also  called  the  Sinus  of  Morgagni,  and  the  lower  part 
of  the  ventricle  is  sometimes  named  the  Sac  of  Hilton. 

What  class  of  Epithelium  lines  the  Larynx  ?  Its  mucous  membrane 
is  covered  with  Ciliated  Epithelium  below  the  level  of  the  superior  vocal 
chords,  extending  in  front  as  high  as  the  centre  of  the  epiglottis.  Over  the 
rest  of  the  larynx  is  Squamous  Epithelium. 

Describe  the  Laryngeal  Muscles.  They  are  4  in  number  on  each  side 
and  one  in  the  median  line,  viz. — 

Crico-thyroid  (2), — from  the  front  and  side  of  the  cricoid  cartilage,<5 — into 
the  lower  and  inner  border  of  the  thyroid.^-  Action,  to  tilt  the  thyroid 
cartilage  forwards,  thus  elongating  and  making  tense  the  vocal  chords. 
Nerve,  superior  laryngeal. 
Crico-arytenoideus  Posticus  (2), — from  the  cricoid  cartilage  posteriorly, — 
into  the  posterior  angle  of  the  base  of  the  arytenoid  cartilage.  Action, 
to  rotate  the  arytenoids  outwards  and  open  the  glottis,  while  keeping  the 
vocal  chords  tense.     Nerve^  recurrent  laryngeal. 


THE   LARYNX. 


169 


Crico-arytenoideus   Lateralis  d  (2), — from  the  Fig.  83. 

upper  lateral  border  of  the  cricoid  cartilage, 
— into  the  posterior  angle  of  the  base  of  the 
arjrtenoid.  Action,  to  rotate  the  arytenoids 
inwards  and  close  the  glottis.  Nerve,  recur- 
rent laryngeal. 

Thyro-arytenoideus '  (2), — from  the  angle  of 
the  thyroid  cartilage  and  the  posterior  surface 
of  the  crico -thyroid  membrane, — into  the 
base  and  anterior  surface  of  the  arytenoid. 
Action,  to  shorten  and  relax  the  vocal  chords 
by  approximating  the  cartilages,  and  to  com- 
press the  sacculus  laryngis.  Nerve,  recurrent 
laryngeal. 

Arytenoideus  (l), — from  the  posterior  surface 

and  outer  border  of  one  arytenoid  cartilage, — into  the  corresponding  parts 
of  the  opposite  cartilage;  having  oblique  and  transverse  fibres,  and  filling 
up  the  posterior  concave  surfaces  of  the  arytenoid  cartilages.  Action,  by 
approximating  the  arytenoids,  to  close  the  back  part  of  the  glottis. 
Nerves,  superior  and  recurrent  laryngeal. 

A  small  fasciculus,  called  the  Kerato-cricoideus,  is  sometimes  found  below 
the  arytenoideus,  extending  from  the  cricoid  cartilage  to  the  inferior  cornu 
of  the  thyroid.  It  occurs  once  in  5  cases,  usually  on  one  side  only,  but 
occasionally  on  both,  and  acts  to  fix  the  lower  horn  of  the  thyroid  carti- 
lage backwards  and  downwards. 

Another  small  muscle  is  found  frequently,  though  rarely  described  in  the 
books,  the  Triticeo-glossus.  It  arises  from  the  cartilaginous  nodule  in  the 
lateral  thyro-hyoid  ligament,  and  passes  forwards  and  upwards  to  enter 
the  tongue  along  with  the  kerato-glossus  muscle. 

Describe  the  Muscles  of  the  Epiglottis.  They  are  3  double  muscles, 
as  follows,  viz. — 

Thyro-epiglottideus  (2), — from  the  mner  surface  of  the  thyroid  cartilage, — 
into  the  margin  of  the  epiglottis,  and  the  aryteno-epiglottidean  fold. 
Action,  to  depress  the  epiglottis,  and  compress  the  sacculus  laryngis. 
Nerve,  recurrent  laryngeal. 

Aryteno-epiglottideus  Superior  (2), — from  the  apex  of  the  arytenoid  carti- 
lage,— into  the  aryteno-epiglottidean  fold.  Action,  to  constrict  the  supe- 
rior aperture  of  the  larynx.     Nerve,  recurrent  laryngeal. 

Aryteno-epiglottideus  Inferior  (2), — from  the  arytenoid  cartilage  just  above 
the  attachment  of  the  superior  vocal  chord, — into  the  sacculus  laryngis 


170  VISCERAL  ANATOMY. 

and  the  margin  of  the   epiglottis.     Action,  to   compress   the   sacculus 
laryngis.     Nerve^  recurrent  laryngeal. 
Name  the  Arteries  and  Veins  of  the  Larynx.     The — 
Arteries, — are  the  Laryngeal  Branches  of  the  superior  and  inferior  thyroid  ; 
and  the  Crico-thyroid  Branches  of  the  superior  thyroid,  which  anastomose 
on  the  crico  thyroid  membrane  with  their  fellows  of  the  opposite  side. 
Veins, — empty  into  the  superior,  middle  and  inferior  thyroid  veins. 

Describe  the  Laryngeal  Nerves.  They  are  the  Superior  and  Recurrent 
Laryngeal  Branches  of  the  pneumogastric,  joined  by  filaments  from  the  spinal 
accessory  and  the  sympathetic.     The — 

Superior  Laryngeal, — is  the  nerve  of  sensation.  It  enters  the  larynx  by  a 
hole  in  the  thyro-hyoid  membrane,  and  supplies  the  mucous  membrane, 
and  the  crico-thyroid  and  arytenoideus  muscles.  It  has  the  following 
branches,  namely — 

External  Laryngeal.  Internal  Laryngeal. 

Recurrent  Laryngeal, — is  the  motor  nerve.  It  winds  from  before  back- 
wards, around  the  subclavian  artery  on  the  right  side,  around  the  arch  of 
the  aorta  on  the  left  side,  and  is  distributed  to  all  the  laryngeal  muscles 
except  the  crico-thyroid, — ^giving  off,  in  its  course,  cardiac,  oesophageal, 
tracheal  and  pharnygeal  filaments,  and  finally  anastomosing  with  the 
superior  laryngeal  nerve. 

THE  TRACHEA  AND  BRONCHI. 

What  is  the  Trachea  ?  A  membrano-cartilaginous,  cyhndrical  tube, 
about  4^  inches  long,  and  ^  to  i  inch  in  diameter,  beginning  at  the  lower 
border  of  the  larynx, ^  opposite  the  5th  cervical  vertebra,  and  ending  opposite 
the  3d  dorsal,  by  its  bifurcation  into  the  two  bronchi.  It  is  composed  of  a 
fibro  elastic  membrane  containing  16  to  20  imperfect  cartilaginous  rings,  con- 
nected by  muscular  fibres.  It  is  lined  with  mucous  membrane  covered  with 
ciliated  columnar  epithelium,  and  furnished  with  glands.  Its  anterior  surface 
is  convex,  its  posterior  surface  flat. 

State  its  Chief  Relations  in  the  Neck  and  Thorax. 
Anteriorly, — it  is  covered  from  above  downwards  by  the — 

Isthmus  of  the  Thyroid  Gland.  Thymus  Gland. 

Inferior  Thyroid  Veins.  Arch  of  the  Aorta. 

Sterno-hyoid  Muscle.  Innominate  Artery. 

Sterno-thyroid  Muscle.  Left  Carotid  Artery. 

Manubrium  of  the  Sternum.  Deep  Cardiac  Plexus. 

Posteriorly, — it  is  in  relation  with  the — 

CEsophagus.  Right  Recurrent  Laryngeal  Nerve. 


THE   LUNGS.  171 

JLaieraIfy, — with  the — 

Common  Carotid  Arteries.  Recurrent  Laryngeal  Nerves. 

Thyroid  Gland.  Pleuree. 

Inferior  Thyroid  Arteries.  Pneumogastric  Nerves. 

Describe  the  Bronchi.     They  are  tv\ro  tubes  similar  in  formation  to  the 
trachea,  extending  from  its  bifurcation  into  the  lungs,  where  they  divide  and  sub- 
divide into  bronchial  tubes,  losing  their  rings  at  the  2d  or  3d  subdivision,  whence 
plates  of  cartilage  extend  in  their  walls  to  their  minuter  ramifications.     The— 
Right  Bronchus, — is  the  widest,  and  the  most  horizontal,  about  i  inch  long, 
has  6  to  8  rings,  and  divides  into  2  main  divisions  (though  its  lung  has 
3  lobes). 
Lefi  Bronchus,— I?,  the  narrowest  and  most  oblique,  nearly  2  inches  long, 
has  9  to  12  rings,  and  divides  into  3  main  divisions  (though  its  lung  has 
2  lobes). 
What  are  the  Relations  of  the  Bronchi  7     Beginning  opposite  the  3d 
dorsal  vertebra,  the  right  bronchus  enters  the  lung  opposite  the  4th  dorsal 
vertebra,  the  left  bronchus  opposite  the  5th.     The  Right  Bronchus  lies  behind 
the  vena  cava  superior  and  the  right  auricle  of  the  heart,  having  the  right  pul- 
monary artery  at  first  below,  then  anterior  to  it,  and  the  vena  azygos  major 
arching  over  it  from  behind  forwards.      The  Left  Bronchus  passes  beneath  the 
arch  of  the  aorta  and  in  front  of  its  descending  portion,  also  in  front  of  the 
oesophagus  and  the  thoracic  duct,  having  the  left  pulmonary^  artery  above  and 
in  front  of  it. 

Name  the  Vessels  and  Nerves  of  the  Trachea  and  Bronchi. 
Arteries, — Tracheal  Branches  of  the  inferior  thyroid  (br.  of  thyroid  axis),  and 

the  Bronchial  (brs.  of  thoracic  aorta). 
Veins, — open  into  the  thyroid  plexus  and  the  bronchial  veins. 
Lymphatics^ — terminate  in  the  mediastinal  glands. 

Nerves, — are   derived  from  the   pneumogastric   and   its  recurrent  laryngeal 
branch,  also  from  the  sympathetic. 

THE  LUNGS. 

Describe  the  Lungs.  The  lungs  are  the  two  essential  organs  of  respiration, 
contained  in  the  cavity  of  the  thorax,  covered  by  the  pleurae,  and  characterized 
by  lightness  (sp.  gr.  0.345  to  0.746),  sponginess,  elasticity,  and  crepitation  when 
pressed.  They  weigh  together  about  42  ounces,  the  right  lung  being  the  heaviest 
by  about  2  ounces.  At  birth  their  color  is  a  pinkish- white,  mottled  as  age  ad- 
vances by  slate  colored  patches,  from  the  deposit  of  carbonaceous  granules  in 
the  areolar  tissue  of  the  organ.  The  Right  Lung  is  the  largest  and  has  3  lobes; 
the  Left  Lung  has  2  lobes.     Each  lung  presents  for  examination  an — 


172 


VISCERAL   ANATOMY. 


A/>ex,'^^ — projecting  into  the  neck  about  an  inch  above  the  1st  rib,  where  U 

is  in  relation  with  the  subclavian  artery  and  the  scaleni  muscles. 
BasCy^^ — is  broad,  concave,  and  directed  obliquely  downwards  and  back 

wards,  resting  on  the  upper  convex  surface  of  the  diaphragm. 
External  Surface, — is  convex,  smooth,  marked  by  the  fissures,  and  corre.. 

sponds  in  form  to  that  of  the  thorax. 
Inner  Surface, — is  concave,  the  left  lung  excavated  for  the  heart,  thf  sur. 

face  forming  part  of  the  walls  of  the  middle  mediastinum. 

Fig.  84. 


Root, — is  where  the  bronchi,  vessels,  and  nerves  enter  the  lung,  bound 
together  by  areolar  tissue.  In  front  of  the  root  is  the  phrenic  nerve, 
behind  it  the  pneumogastric  nerve.  Its  chief  structures  are  arranged  in 
the  following  manner  : — 

r  Pulmonary  veins. 
Prom  before,  backwards.        X  Pulmonary  artery.  ^  ^N .  K.  B. 
(^  Bronchus,  etc. 


THE  LUNGS. 


173 


„  ,  ,  -  r  Bronchus,  etc. 

From  above,  downwards,  on  >  ^  , 

•  1-.    -J      r  1.    J  i  Pulmonary  artery, 

right  side  of  body.  i  ^  ■,  . 

V.  Pulmonary  vems. 

T,  ,  ,  ,  r  Pulmonary  artery, 

rrom  above,  downwards,  on  i  ^        , 

,  ,,    . ,      ^  ,     ,  \  Bronchus,  etc. 

left  sid£  of  body.  y  t^  , 

i^  Pulmonary  vems. 


B.  A,  V. 


A.  B.  V. 


Fig.  85. 


Describe  the  Structure  of  the  Lung.  The  lung  has  a  serous  coat  (the 
pleura) ;  a  sub-serous,  elastic  areolar  tissue,  investing  the  entire  organ,  and  ex- 
tending inwards  between  the  lobules ;  and  the  parenchyma,  or  true  lung-tissue, 
composed  of — 

Lobules, — each  consisting  of  several  air- 
cells  or  compartments,  arranged  around 
the  termination  of  a  bronchiole,  and 
surrounded  by  6  plexuses  of  pulmon- 
ary and  bronchial  arteries  and  veins, 
lymphatics  and  nerves.  Each  lobule 
is  a  miniature  lung,  pyramidal  in  form, 
with  base  outwards,  and  about  -^^  inch 
in  diameter. 
Alveoli,  or  Air-cells, — are  separated  from 
each  other  by  thin  septa,  are  lined 
with  pavement  epithelium  on  a  base- 
ment membrane,  and  vary  in  diam- 
eter from  y^^  to  Tj?^  inch.  [See  Fig. 
85.] 

Name  the  Vessels  and  Nerves  of  the  Lungs.  The  lungs  are  nour- 
ished by  the  bronchial  arteries,  and  supplied  with  blood  for  oxygenation  by 
the  pulmonary  arteries. 

Bronchial  Arteries, — are  derived  from  the  thoracic  aorta. 

Pulmonary  Arteries, — are  derived  from  the  right  heart. 

Bronchial  Veins, — open  on  the  right  side  into  the  vena  azygos,  on  the  left 
side  into  the  superior  intercostal  vein. 

Pulmonary  Veins, — open  by  4  large  orifices  into  the  left  auricle  of  the 
heart,  carrying  oxygenated  blood  from  the  lungs  to  the  heart. 

Lymphatics, — terminate  in  the  bronchial  glands. 

Nerves, — are  branches  from  the  pneumogastric  and  the  sympathetic,  form- 
ing the  Anterior  and  Posterior  Pulmonary  Plexuses,  from  which  filaments 
are  distributed  to  each  lobule. 


174  VISCERAL   ANATOivIY. 

THE  PLEURiE. 
What  are  the  Pleurae  ?     Two  delicate  serous  sacs,  one  surrounding  each 
lung  and  reflected  over  the  pericardium,  the  diaphragm,  and  the  inner  surface 
of  the  thorax. 

Where  do  the  Pleurae  meet  ?     For  a  short  space  behind  the  middle  of 
the  sternum,  at  the  approximation  of  the  anterior  borders  of  the  lungs. 
What  Names  are  given  to  the  parts  of  the  Pleurae  ?     The — 
Pleura  Pulmonalis,  or  Visceral  Layer, — covers  the  lung,  and  invests  that 

organ  as  far  as  its  root. 
Pleura  Costalis,  or  Parietal  Layer, — lines  the  inner  surface  of  the  parietes  of 

the  chest. 
Cavity  of  the  Pleura, — is  the  space  between  the  two  layers. 

W^hat  is  the  Ligamentum  Latum  Pulmonis  ?  The  Broad  Ligament 
of  the  Lung  is  a  triangular  fold  or  reflection  of  pleura,  which  descends  from 
rhe  root  of  the  lung  posteriorly  to  the  upper  surface  of  the  diaphragm. 

State  the  Differences  between  the  Pleurae.  The  right  sac  is  shorter, 
wider,  and  reaches  higher  into  the  neck  than  the  left. 

Enumerate  the  Parts  in  Relation  with  the  Left  Pleura.     Its — 
Visceral  Layer, — is  in  contact  with  the  left  lung. 

Parietal  Layer, — is  in  relation  with  the  vertebral  column,  the  ribs,  intercostal 
muscles  and  vessels,  the  sternum,  the  left  sympathetic  nerve,  the  diaphragm, 
the  arched  portion  of  the  subclavian  artery,  and  the  origin  of  the  left  carotid, 
the  left  pneumogastric,  phrenic  and  cardiac  nerves,  the  trachea,  oesophagus, 
aorta  and  the  pericardium. 

What  is  the  Mediastinum  ?  It  is  the  space  between  the  two  pleurae  in 
the  median  line  of  the  thorax,  extending  from  the  sternum  to  the  vertebral 
column,  and  containing  all  the  thoracic  viscera  except  the  lungs. 

Enumerate  the  Contents  of  each  of  its  Divisions.     The — 
Anterior  Mediastinum,  contains  the — 

Origins  of  the  Sterno-hyoid  and  Sterno-thyroid  Muscles. 
Triangularis  Sterni  Muscle.  Thymus  Gland. 

Left  Internal  Mammary  Vessels.  Lymphatics. 

Middle  Mediastinum,  contains  the — 

Heart  and  Pericardium.  Bifurcation  of  the  Trachea. 

Ascending  Aorta.  Pulmonary  Arteries  and  Veins. 

Superior  Vena  Cava.  Phrenic  Nerves. 

Posterior  Mediastinum,  contains  the — 

Descending  Aorta.  Pneumogastric  Nerves. 

Azygos  Veins.  Splanchnic  Nerves. 

Superior  Intercostal  Veins.  Thoracic  Duct. 

Lymphatic  Glands, 


THE   KIDNEYS. 


176 


THE    URINARY   ORGANS. 
THE  KIDNEYS. 

Where  are  the  Kidneys  situated  ?  Posteriorly  in  the  abdomen,  one  on 
each  side  of  the  spinal  column,  behind  the  peritoneum,  and  extending  from 
the  level  of  the  nth  rib  to  near  the  crest  of  the  ileum.  The  right  kidney  is 
lower  than  the  left. 

State  their  Dimensions.  Each  one  is  about  4  inches  by  2  by  i,  and 
weighs  from  4  to  6  oz. 

Enumerate  their  Relations.     The — 
Anterior  Surface  of  the  Right  Kidney, — is  in  relation  with  the  right  lobe  of 

the  liver,  descending  duodenum,  and  the  ascending  colon. 
Anterior  Surface  of  the  Left  Kidney, — with  the  tail  of  the  pancreas,  descen-:/- 

ing  colon,  and  part  of  the  spleen. 
Posterior  Surface, — with  the  crus  of  the  diaphragm,  nth  and  12th  ribs,  psoas 

magnus,  quadratus  lumborum,  and  the  aponeurosis  of  the  transversalis  muscle. 
Superior  Extre?nity, — is  capped  by  the  supra-renal  capsule. 

Describe  the  Hilum  of  the  Kidney.    The  Hilutn  is  a  fissure  on  the  inner  or 
concave  border,  leading  into  the  Sinus  or  cavity  of  the  gland.    It  contains  the-^ 
Renal  Vein, — in  front.  Renal  Artery, — next  in  order. 

Ureter,  or  Excretory  Duct, — ^behind  and  below. 

Describe  the  Kidney-structure.     A  vertical  section  presents  the — 
Pelvis  or  Sinus, ^ — the  cavity,  forming  the  beginning  of  the  ureter  ^  or  ex' 

cretory  duct  of  the  gland.      Its  divisions  are 

the    3   Infundibula  ^,  and   these   are   again 

divided  into  Calices  *  or  pouches,  into  which 

open  the  orifices  of  the  pyramids,  looo  orifices 

situated  on  each  Papilla. 
Medullary  Substance ^^ — consists   chiefly  of  the 

tubes  of  Bellini  and  Henle,  arranged  in  Pyra- 
mids of  Malpighi,  whose  apices  project  into 

the  calices  of  the  pelvis. 
Cortical  Substance,'^ — forms  the  surface  of  the 

gland,    and    consists    of    uriniferous  tubules 

(straight  and  convoluted),  Malpighian  bodies, 

blood-vessels,  nerves,  lymphatics,  connective 

tissue,  and  a  granular  matrix.     It  is  of  a  red 

color,  and  is  prolonged  down  to  the  pelvis  be- 
tween the  pyramids,  these  prolongations  being 

named  the  Columns  of  Bertin. 


Fig.  86. 


176 


VISCERAL  ANATOMY. 


Describe  the  Tubuli  Uriniferi.     The  uriniferous  tubes  begin  at  the  Mai- 
pighian  corpuscles  in  the  Capsules  of  Miiller,  and  end  at  the  orifices  on  the 
surfaces  of  the  papillae.     Their  various  portions  are  the — 
Convoluted  Tubes  of  Ferrein, — in  the  cortical  substance. 
Looped  Tubes  of  Henle, — descending  from  the  former  and  ascending  into 

the  next  mentioned. 
Straight  Tubes  of  Bellini, — in  the  medullary  substance,  arranged  in  pyra- 
mids, the  Pyramids  of  Malpighi. 

What  are  the  Pyramids  of  Ferrein  ?  They  are  pyramidal  arrangements 
of  the  tubes  of  Ferrein  at  the  bases  of  the  pyramids  of  Malpighi. 

What  are  the  Malpighian  Bodies  ?  They  are  small  red  bodies  found  in 
the  cortical  substance,  each  formed  by  the  dilated  extremity  of  a  tube  of  Fer- 
rein, about  the  yi^  inch  in  diameter,  and  consisting  of  the — 

Malpighian  Tuft, — a  tuft  of  capillary  vessels,  the  termination  of  some 
branches  of  the  renal  artery  «  and  y€\n.v 
Capsule  of  Muller,c — the  dilated  extremity  of  a 
tube  of  Ferrein,^  investing  the  Malpighian  tuft 
probably  by  two  layers,  similar  to  the  pleural 
investment  of  the  lungs. 

How  is  the  Kidney  invested  7  By  a  dense 
fibrous  Capsule,  which  is  continued  inwards  at  the 
hilum,  to  line  the  sides  of  the  sinus  and  form  sheaths 
around  the  vessels.  The  kidney  is  also  surrounded 
by  a  large  quantity  of  fat. 

Enumerate  the  various  Divisions  of  the  Renal 
Vessels.      They  are   all    derived   from   the   Renal 
Artery  and  the  Renal  Vein,  but  in  their  course  have 
received  different  names,  as  follows,  viz. — 
Renal  Artery, — branch  of  the  abdominal  aorta.     Divides  into  the — 
Primary  Branches,  4  or  5, — arising  just  external  to  the  hilum,  again  sub- 
divide and  enter  in  the  columns  of  Bertin  as  the  Arterise  Proprias  Renales, 
which  form — 
Arterial  Arches, — over  the  bases  of  the  pyramids,  and  divide  into  ascend- 
ing and  descending  branches. 
Interlobular  Arteries,  or  Ascending  Branches, — supply  the  cortical  sub- 
stance, and  end  in  the  Stars  of  Verheyen.     (See  next  page.) 
Arterioles  RectcE,  or  Descending  Branches, — supply  the   medullary  pyra- 
mids, ending  in  venous  plexuses  therein. 
Afferent  Vessels, — to  the  Malpighian  bodies,  from  the  ascending  branches. 


THE  URETERS.  .  l77 

Malpighian   Tufts, — are  capillary  plexuses  within  the  Malpighian  bodies. 
From  them  arise  the — 

Efferent  Vessels, — whether  arterial  or  venous,  is  undecided.     They  form 
Venous  Plexuses, — on  the  convoluted  uriniferous  tubes. 

Stars  of  Verheyen, — are  venous  plexuses  of  stellate  form,  situated  on  the 
surface  of  the  kidney,  beneath  its  capsule,  joining  to  form  the — 

Interlobular  Veins, — from  the  cortical  portion ;  which  with  the 
VencE  RectcB, — from  the  medullary  pyramids,  making 
Venous  Arches, — over  the  bases  of  the  pyramids,  finally  meet  in  the— • 

VencB  Propric?  Renales, — and  they  end  in  the 

Renal  Vein, — which  empties  into  the  inferior  vena  cava. 

Whence  are  the  Nerves  of  the  Kidney  derived  ?  From  the  Renal 
Plexus,  which  is  formed  by  filaments  from  the  solar  plexus  and  the  lesser 
splanchnic  nerve. 

THE  URETERS. 

What  is  the  Ureter  "i  The  excretory  duct  of  the  kidney,  forming,  by  Its 
upper  expanded  portion,  the  cavity  of  that  gland.  It  is  a  musculo-membra- 
nous  tube,  i6to  i8  inches  long,  as  large  as  a  small  goose-quill;  and  ends 
at  the  base  of  the  bladder,  into  which  it  opens  obliquely  by  a  constricted 
orifice,  about  2  inches  from  the  orifice  of  its  fellow.  The  ureter  commences 
in  the — 

Calices,—']  to   13  small  tubes,  embracing  the  papillae  of  the  kidney,  and 
joining  to  form  the — 

Infundibula, — 3  or  4  in  number,  which  unite  in  the — 

Pelvis, — a  funnel-shaped  dilatation  of  the  upper  portion  of  the  ureter. 

Describe  its  Course.  It  descends  obliquely  inwards  along  the  posterior 
wall  of  the  abdomen,  enters  the  posterior  false  ligament  of  the  bladder  in  the 
male,  and  that  of  the  uterus  in  the  female,  through  which  it  passes  forwards 
and  inwards  to  the  posterior  angle  of  the  trigone  vesicae,  lying  between 
the  muscular  and  mucous  coats  of  the  bladder,  for  about  three-fourths 
of  an  inch. 

What  are  its  Relations  ?  It  lies  upon  the  psoas  muscle,  behind  the  peri- 
toneum and  below  the  spermatic  vessels,  over  the  common  iliac  or  the  external 
iliac  artery,  behind  the  ileum  on  the  right  side,  behind  the  sigmoid  flexure 
on  the  left.  The  right  ureter  lies  close  to  the  outer  side  of  the  inferior 
vena  cava. 

Describe  its  Structure.     The  ureter  has  3  coats — a  fibrous,  a  muscular, 
and  a  mucous ;    the  epithelium  of  the  mucous  coat  is  different  from  that 
of  the  urethra,  the  bladder,  or  the  uriniferous  tubes,  being  spheroidal  in 
shape. 
L 


178  .  VISCERAL  ANATOMY. 

THE  BLADDER. 
What  is  the  Bladder  ?     It  is  the  urinary  reservoir,  a  musculo-membra 
nous  sac,  situated  in  the  anterior  portion  of  the  pelvis,  behind  the  pubes. 
When  moderately  distended  it  measures  about  5  by  3  inches,  and  holds  about 
a  pint.     Its — 

Summit, — is  connected  to  the  umbilicus  by  the 
Urachus  and  the  obliterated  Hypogastric 
Arteries  of  the  foetus,  forming  three  fibrous 
cords,  the  Superior  Ligament  of  the  bladder. 
Body, — is  in  relation  in  front  with  the  triangular 
ligament,  the  symphysis  pubis,  and  the  in- 
ternal obturator  muscles, — behind  it  is  cov- 
ered by  peritoneum,  and  is  in  relation 
with  the  rectum  in  the  male,  with  the 
uterus  and  upper  part  of  the  vagina  in  the 
female.  Each  side  is  crossed  obliquely  by 
the  obliterated  hypogastric  artery  and  the  vas 
deferens,^  the  first  passing  from  below  for- 
/  wards,  the  latter  from  below  backwards. 

Fundus  or  Base, — rests  on  the  second  portion  of  the  rectum  in  the  male,  on 
the  lower  part  of  the  cervix  uteri  and  adherent  to  the  anterior  wall  of  the 
vagina  in  the  female.  It  is  partly  covered  by  peritoneum. 
Cervix  or  Neck, — is  constricted  and  continuous  with  the  urethra.*'  It  is  sur- 
rounded in  the  male  by  the  prostate  gland/  and  is  directed  downwards 
and  forwards. 

Name  the  Ligaments  of  the  Bladder.  They  number  10,  of  which  5 
are  true  ligaments,  and  5  are  false,  the  latter  being  folds  of  peritoneum.  They 
are  named  as  follows, — 

True  Ligaments.  False  Ligaments. 

2  Anterior  (pubo- prostatic).  2  Posterior. 

2  Lateral.  2  Lateral. 

Superior  (the  Urachus,  etc.).  Superior. 

What  is  the  Urachus  ?  It  is  the  obliterated  remains  of  a  canal,  which 
in  the  embryo  connects  the  bladder  with  the  allantois.  It  is  situated  between 
the  two  obliterated  hypogastric  arteries,  and  with  them  forms  the  superior  liga- 
ment of  the  bladder,  connecting  the  summit  of  that  organ  with  the  umbilicus. 
What  is  the  Trigonum  Vesicae  ?  C^,  Fig.  89.)  The  Vesical  Trigone  is 
a  triangular  space,  of  pale  color,  at  the  base  of  the  bladder  interiorly,  charac- 
terized by  its  smooth  surface  and  the  intimate  adhesion  between  its  mucous 
and  muscular  coats.     Its  boundaries  are — 


THE  URETHRA.  179 

In  Front, — the  urethral  opening. 

Posteriorly, — a  line  connecting  the  orifices  ^  of  the  ureters. 
Laterally, — two  ridges  of  mucous  membrane,  which  extend  from  the  ure- 
thral orifice  back  to  th-  orifices  of  the  ureters. 

What  is  the  Uvula  Vesicae  ?  (^,  Fig.  89.)  A  small  elevation  of  mu- 
cous membrane  projecting  from  the  floor  of  the  bladder  into  the  urethral  orifice. 
It  is  said  to  be  Hfted  by  the  anterior  fibres  of  the  levator  ani  muscle. 

Describe  the  Structure  of  the  Bladder.  It  has  a  partial  peritoneal  in- 
vestment, and  its  walls  are  composed  of  3  coats, — a  muscular,  a  cellular,  and 
a  mucous.     The — 

Muscular  Coat, — consists  of  5  sets  of  fibres,  as  follows, — 
External  and  Internal  Longitudinal  fibres. 
Intermediate  Circular  fibres,  forming  a  Sphincter  Vesicce  at  the  neck  of 

the  bladder. 
Transverse  fibres,  connecting  the  orifices  of  the  ureters. 
Muscles  of  the  Ureters,  connecting  their  orifices  with  the  middle  lobe  of 
the  prostate  gland. 
Cellular  Coat, — connects  the  other  two  coats  together,  and  is  closely  attached 

to  the  mucous  coat. 
Mucous  Coat, — is  covered  with  epithelium  intermediate  in  form  between  the 
columnar  and  the  squamous  ;   is  loosely  connected  to  the  muscular  coat, 
except  at  the  trigone  vesicale  and  the  uvula  vesicae,  where  it  is  closely 
adherent. 

What  Nerves  supply  the  Bladder  }  Branches  from  the  hypogastric 
plexus  supply  its  upper  part, — from  the  sacral  plexus  its  base  and  neck. 

The  Male  Urethra. 
What  is  the   Urethra  ?     It  is  the  urinary  canal  from  the  neck  of   the 
bladder  to  the  meatus  urinarius ;  in  the  male  it  is  chiefly  within  the  penis,  and 
from  8  to  9  inches  in  length. 

Enumerate  its  Divisions.  The  male  urethra  is  divided  into  3  parts, — 
the  prostatic,  membranous  and  spongy. 

Describe  the  Prostatic  portion  of  the  Urethra.  ^^  It  is  that  part  of 
the  canal  which  pierces  the  prostate  gland,i2  is  about  i^  inch  in  length,  of 
spindle-shape,  and  is  the  widest  and  most  dilatable  part  of  the  urethra.  Its 
floor  presents  the — 

Veru  Montanum,  or  Caput  Gallinaginis,^ — an  elevation  of  the  mucous 
membrane  and  its  adjacent  tissue,  3^  inch  long,  and  supposed  to  contain 
muscular  and  erectile  tissue. 


180 


VISCERAL   ANATOMY. 


pjg  g^^  Prostatic  Sinus, ^"^ — one  on  each  side  of 

the  veru  montanum,  containing  the 
orifices  of  the  prostatic  ducts. 
Sinus  Pocularis,  or  Uterus  Masculinus,^ 
— a  small  cul-de-sac  situated  at  the 
front  part  of  the  veru  montanum.  It 
extends  for  ^  inch  upwards  and  back- 
wards into  the  prostate  gland,  beneath 
its  middle  lobe. 
Orifices  of  the  Seminal  Ducts, — open 
on  the  margins  of  the  sinus  pocularis. 

Describe  the  Membranous  portion 
of  the  Urethra.  15  it  is  ^  inch  long 
above,  and  ^  inch  along  its  floor,  being 
that  part  of  the  canal  lying  between  the 
layers  of  the  triangular  ligament  of  the 
perineum.  Its  walls  are  very  thin,  and 
almost  destitute  of  erectile  tissue.  It  is 
surrounded  by  the  compressor  urethrse  mus- 
cle, and  except  the  orifice,  is  the  narrowest 
part  of  the  urethral  canal.  On  its  sides  are 
the— 

Ducts  of  Cowper's  Glands, "^^—ow  their 
way  to  open  into  the  bulb  of  the 
urethra.     (See  p.  182.) 

Describe  the  Spongy  portion  of  the 
Urethra.  It  is  about  6  inches  long,  and 
has  two  dilatations,  one  at  each  end,  named 
respectively  the  Bulb  and  the  Fossa  Na- 
vicularis.     The — 

Bulb  of  the   Urethra,^  ^ — is  the  upper 
end  of  the  spongy  portion,  projects  backwards  for  ^  inch,  and  contains 
the  orifices  of  Cowper's  glands. 
Fossa  Navicular's, — is  the  lower  dilatation  of  the  urethra,  and  is  situated 

within  the  glans  penis. 
Lacuna  Magna, — the  largest  of  several  orifices  of  mucous  follicles,  situated 

on  the  roof  of  the  fossa  navicularis. 
Glands  of  Littri, — are  numerous  mucous  glands  and  follicles,  opening  into 
the  urethral  canal,  their  orifices  being  directed  forwards. 


THE  URETHRAL  GLANDS.  181 

Describe  the  Structure  of  the  Urethra.  It  has  3  coats,  a  mucous,  a 
muscular,  and  an  erectile.     The — ■ 

Mucous  Coat, — is  continuous  with  that  of  the  whole  urinary  tract  and  the 
ducts  of  the  glands  opening  therein.  Its  epithelium  is  columnar,  except 
in  the  fossa  navicularis,  where  it  is  squamous. 

Muscular  Coat, — consists  of  a  layer  of  longitudinal  fibres  of  the  unstriped 
variety.  [For  the  voluntary  muscles  of  the  urethra,  see  the  Compressor 
Urethroe  and  Accelerator  Urinae,  page  84.] 

Erectile  Coat, — is  the  corpus  spongiosum  of  the  penis,  and  a  thin  layer  con- 
tinued therefrom  around  the  membranous  and  prostatic  portions. 

The  Female  Urethra, 
Enumerate  the  Characteristics  of  the  Female  Urethra.  It  is  about 
I  j^  inch  long,  imbedded  in  the  anterior  wall  of  the  vagina,  perforating  the 
triangular  ligament,  and  surrounded  by  the  fibres  of  a  compressor  urethrge 
muscle.  Its  diameter  is  about  ]^  inch,  but  it  is  capable  of  considerable 
dilatation,  being  surrounded  by  softer  structures  than  those  around  the 
male  urethra. 

THE  MALE  GENERATIVE  ORGANS. 

THE  URETHRAL  GLANDS. 
Where   is    the    Prostate    Gland  ?     It  encircles  the  neck  of  the  male 
bladder,  its  apex  touching  the  deep  perineal  fascia,  its  under  surface  resting  on 
the  rectum.     It  is  perforated  by  the  urethra  and  the  common  seminal  ducts, 
and  its  ducts  open  into  the  prostatic  portion  of  the  urethra. 

State  its  Dimensions  and  Characteristics.  It  measures  about  ij^  inch 
by  I  inch  by  |^  inch,  weighs  about  ^y^  oz.,  resembles  a  horse-chestnut  in  size 
and  shape,  and  consists  of  three  lobes,  two  being  lateral  and  of  equal  size,  the 
third  or  middle  lobe  being  a  small  prominence  situated  in  the  notch  between 
the  lateral  lobes. 

Describe  its  Structure.  The  prostate  gland  is  composed  of  glandular 
substance  and  muscular  tissue,  inclosed  in  a  fibrous  capsule. 

How  is  it  Held  in  Position  ?  By  the  pubo  prostat'C  ligaments  of  the 
bladder,  the  posterior  layer  of  the  deep  perineal  fascia,  and  by  the  anterior 
portion  of  the  levator-ani  muscle. 

Where  are  Cowper's  Glands  ?  They  are  situated  between  the  two  layers 
of  the  deep  perineal  fascia,  one  on  each  side  of  the  membranous  portion  of 
the  urethra,  close  behind  the  bulb,  and  inclosed  by  the  transverse  fibres  of  the 
compressor  urethroe  muscle. 


182  VISCERAL  ANATOMY. 

Where  do  their  Ducts  open  ?  On  the  floor  of  the  bulbous  part  of  the 
spongy  portion  of  the  urethra,  after  traversing  the  wall  of  the  urethra  for  about 
one  inch,  between  its  mucous  and  muscular  coats. 


THE  PENIS. 
Of  what  is  the  Penis  composed  ?  Of  a  mass  of  erectile  tissue  arranged 
in  three  compartments  of  cylindrical  shape,  each  surrounded  by  a  fibrous 
sheath  which  is  prolonged  inwards,  forming  numerous  bands  (trabeculse), 
which  divide  the  compartment  into  a  number  of  spaces.  The  compartments 
are  named  the  Corpora  Cavernosa  i  and  the  Corpus  Spongiosum, 2  the  latter 
lying  between  and  beneath  the  former,  like  the  ramrod  of  a  double  barreled 
gun. 

Describe  the  Corpora  Cavernosa.     (i9,  Fig.  89.)     They  lie    side    by 
FiG.-go.  side,  forming  the  upper  and  lateral  parts  of  the 

^  ^    3^  4   S  penis,  are  joined  together  along  their  anterior 

iM^^.®.^  three- fourths,  their  posterior  one-fourth  form- 

ing  the  Crura,  which  arise  from  the  tuberosi- 
ties of  the  ischia  and  their  descending  rami, 
and  meet  beneath  the  symphysis  pubis,  forming 
two  grooves,  one  above  for  the  dorsal  vessels  ^, 
*  and  nerves,  5  the  inferior  one  for  the  corpus 
spongiosum.  2 

Bu/d  of  the  Corpus  Cavernosum, — is  a  slight 
enlargement  on  each  crus,  near  its  junction  with  its  fellow. 
Suspensory  Ligament,— z.  fibrous  membrane  which  connects  the  root  of  the 

organ  to  the  symphysis  pubis. 
Septum  Pectiniforme, — is  a  portion  of  the  fibrous  septum  between  the  corpora 
cavernosa.     This  septum  extends  but  two-thirds  along  the  penis,  and  is 
wanting  for  its  anterior  third. 

Describe  the  Corpus  Spongiosum.  It  is  an  erectile  tube  lying  in  the 
inferior  groove  between  the  two  corpora  cavernosa,  having  within  it  the 
urethra,  and  being  expanded  at  both  ends  to  form  the  glans  penis  and  the 
bulb.  It  is  composed  of  trabecular  (band-like)  structure,  derived  from  a 
fibrous  sheath,  and  containing  erectile  tissue.     The— 

Bulb  of  the  Corpus  Spongiosum, — receives  the  urethra  and  is  surrounded  by 

the  accelerator  urinse  muscle. 
Glans  Penis, — is  the  external  expansion  of  the   corpus  spongiosum,  and 
covers  by  its  base  the  ends  of  the  two  corpora  cavernosa.     Its  base  pre- 
sents a  rounded  border,  called  the   Corona  Glandis,  behind  which  is  a 
deep  sulcus,  the  Cervix. 


THE  TESTES   AND   THEIR   APPENDAGES.  183 

Meatus  Urinartus, — the  external  orifice  of  the  urethra,  is  situated  at  the 
summit  of  the  glans  penis. 

Prepuccy — a  prolongation  of  the  integument  of  the  penis,  covering  or  partly 
covering  the  glans  penis. 

Frenum  Preputii, — a  fold  of  mucous  membrane  lying  along  the  raph6  of 
the  glans  penis,  and  connecting  the  prepuce  thereto. 

Glands  of  Tyson, — small  lenticular  sebaceous  glands  opening  on  the  corona 
and  cervix  of  the  glans,  and  secreting  an  odorous  sebaceous  matter,  which 
is  easily  decomposed. 

Of  what  does  Erectile  Tissue  consist  ?  Of  an  intricate  venous  plexus, 
supplied  by  afferent  arteries  and  emptied  by  efferent  veins.  Such  are  the 
essential  features  of  the  erectile  tissue  of  the  penis,  which  is  lodged  in  the 
interspaces  between  the  trabeculse  of  the  fibrous  structure. 

What  are  the  Helicine  Arteries  ?  They  are  peculiar  vine-like  arterial 
branches,  which  project  in  a  convoluted  manner  into  the  venous  plexuses  in 
the  posterior  portion  of  the  penis. 

Enumerate  the  Vessels  and  Nerves  of  the  Penis.     Its — 
Arteries, — are  derived  from  the  internal  pudic,  and  are  the — 

Artery  of  the  Bulb, — to  the  corpus  spongiosum. 

Artery  of  the  Corpus  Cavernosum, — to  that  structure. 

Dorsal  Artery  of  the  Penis, — to  the  glans,  prepuce  and  skin. 
Veins, — empty  into  the  Dorsal  Vein  of  the  Penis,  the  prostatic  plexus  and  the 

pudic  vein.     The  venous  plexuses  of  the  erectile  tissue  are  very  intricate, 

and  remarkably  developed. 
Lymphatics, — the  superficial  terminate  in  the  inguinal  glands ;  the  deep  set 

joins  the  deep  lymphatics  of  the  pelvis. 
Nerves, — are   derived    from   the   internal   pudic  nerve,  and  the  hypogastric 

plexus  of  the  sympathetic. 

THE  TESTES  AND  THEIR  APPENDAGES. 

What  are  the  Testes  ?  The  Testes  or  Testicles  are  the  glandular  organs 
which  secrete  the  seminal  fluid, — two  oval  bodies  suspended  obliquely  in  the 
scrotum  by  the  spermatic  cords,  each  measuring  about  an  inch  in  diameter, 
and  weighing  |^  oz.  to  an  ounce. 

What  is  the  Scrotum  ?  A  cutaneous  pouch,  consisting  of  2  layers — the 
integument  and  the  Dartos, — the  latter  being  a  contractile  vascular  tunic,  con- 
tinuous with  the  superficial  fascia  of  the  thighs  and  perineum,  and  forming  a 
septum  in  the  scrotum  between  the  two  cavities  for  the  testes. 

Describe  the  Essential  Coats  of  the  Testis.  They  are  3  in  number, 
as  follows,  viz. :  the — - 


184 


VISCERAL  ANATOMY. 


Tunica  Vaginalis,  the  Serous  Covering, — having  a  visceral  layer  (tunica 
vaginalis  propria)  and  a  parietal  layer  (tunica  vaginalis  reflexa).     It  was 


Fig.  91. 


originally  derived  from  the  peritoneum,  and 
the  upper  part  being  obliterated,  it  remained 
a  closed  sac.     (See  «  Fig.  91.) 

Tunica  Albuginea,  the  Fibrous  Covering, — 
formed  of  white  fibrous  tissue,  and  forming 
an  incomplete  vertical  septum  within  the 
gland,  the  Corpus  Highmorianum  or  Medi- 
astinum Testis,^  from  which  fibrous  bands 
(trabeculae)  cross  the  gland,  dividing  its  inte- 
rior into  spaces  for  the  lobules  of  the  organ. 

Tunica  Vasculosa,  the  Pia  Mater  Testis, — is 
the  vascular  tunic,  lying  beneath  the  tunica 
albuginea,  and  giving  off  numerous  pro- 
cesses between  the  lobules. 

Name  the  Coverings  of  the  Testicle.  From  without  inwards  they  are 
6  in  number,  as  follows,  the — 

(i)  Skin, — of  the  scrotum,  closely  adherent  to  the  dartos. 

(2)  Dartos, — or  superficial  fascia. 

(3)  External  Spermatic  Fascia,  Intercolumnar  Fascia, — derived  from  the 

margins  of  the  external  abdominal  ring. 

(4)  Cremasteric  Fascia, — derived  from  the  lower  border  of  the  internal 

oblique  muscle.     [Called  also  the  Cremaster  Muscle.] 

(5)  Internal  Spermatic  Fascia,  or  Fascia  Propria, — the   infundibuliform 

process  of  the  transversalis  fascia. 

(6)  Tunica  Vaginalis,^ — originally  a  process  of  peritoneum.     [Shown  by 

dots  in  Fig.  91.] 
Describe  the  Structure  of  the  Testicle.  The  glandular  structure  is 
composed  of  small,  convoluted  tubes,  the  Tubuli  Seminiferi,^  (Fig-  92),  which 
are  collected  into  Lobules,  about  300  in  number,  from  which  straight  ducts, 
the  Vasa  Recta,^  enter  the  mediastinum  and  form  an  ascending  plexus  of 
anastomosing  tubes,  the  Rete  Testis,^  which  gives  off  some  12  to  20  ducts,  the 
Vasa  Efferentia;  ^  these  perforate  the  tunica  albuginea  of  the  testis,  and 
form  a  number  of  conical  masses,  the  Coni  Vasculosi,'^  which  together  con- 
stitute the  Globus  Major  ^  of  the  Epididymis.  ^ 

What  is  the  Epididymis  ?  ^  It  is  an  appendix  to  the  testicle,  lying 
along  its  posterior  border,  and  consists  of  a  single  duct  about  20  feet  in  length 
when  unraveled,  but  which  is  wound  upon  itself  so  as  to  occupy  a  very  small 
space.     The — 


THE   TESTES   AND   THEIR   APPENDAGES. 


185 


Globus  Major,'' — is  formed  by  the  coni  vasculosi,  Fig.  92. 

or   efferent   ducts   of  the   testis,  which   therein 

open  into  the  single  duct  which  forms  the  epi- 
didymis. 
JBody,^ — is  formed  by  the  convolutions  of  the  tube, 

held  together  by  fine  connective  tissue,  and  is  the 

central  portion. 
Globus    Minor, ^ — the    lower    expanded    portion, 

similarly  formed,  and  connected  to  the  testis  by 

fibrous  tissue. 
Vasculum  Aberrans,'^'^ — a  narrow  tube,  sometimes 

found  opening  into  the  canal  of  the  epididymis 

near  its  lower  end,  and  ending  in  a  blind  ex- 
tremity. 
Hydatids  o/Morgagni, — small  pedunculated  bodies, 

found  attached  to  the  epididymis  or  to  the  upper 

end  of  the  testicle.     One  of  them  is  beheved  to 

be  the  remains  of  the  duct  of  Muller.    (See  CoM- 

PEND  OF  Physiology,  page  131.) 

Describe  the  Vas  Deferens.^"  It  is  the  continuation  of  the  epididymis, 
and  is  the  excretory  duct  of  the  testicle.  Beginning  at  the  globus  minor  it 
ascends  along  the  back  of  the  spermatic  cord  to  the  external  abdominal  ring, 
where  it  enters  the  inguinal  canal,  and  penetrates  the  abdominal  cavity 
through  the  internal  abdominal  ring.  Descending  into  the  pelvis  it  passes 
between  the  bladder  and  the  rectum,  along  the  inner  side  of  the  vesicula 
seminalis,  and  at  the  base  of  the  prostate  gland  it  joins  with  the  duct  of  the 
vesicula  seminalis  to  form  the  ejaculatory  duct.  The  vas  deferens  is  about 
2  feet  long,  and  has  a  canal  of  only  half  a  line  in  diameter.  Its  walls  are 
very  dense,  making  it  feel  like  a  piece  of  wire  or  whip-cord  when  grasped 
between  the  fingers.     (2  Fig.  91.) 

Name  the  Arteries  of  the  Testicle.     The  Spermatic  Artery  ^  supplies 

the  gland  itself;  but  the  coverings  of  the  testicle  are  supplied  by  the — 

Superficial  External  Pudic,  ~|       ,  ,  .   .     ^  . 

^      -^ ^  ,  _,    ,.  \ — branches  of  the  remoral. 

Deep  External  Fudic,  J 

Superficial  Perineal,— hr.  of  the  Internal  Pudic,  from  the  Int.  Iliac. 

Cremasteric, — branch  of  the  Epigastric,  from  the  External  Iliac. 

Name  the  Nerves  of  the  Testicle.     They  are  the — 

^  .    .^  * .     I  —branches  of  the  Lumbar  Plexus. 

Ilio- hypogastric,  \ 

Superficial  Perineal,— hrzYich.  of  the  Internal  JPudic  nerve.. 


186  VISCERAL  ANATOMY. 

Inferior  Pudendal, — ^branch  of  the  Small  Sciatic  nerve. 
Genital, — branch  of  the  Genito-crural  nerve. 

Describe  the  Spermatic  Cord.  It  extends  from  the  internal  abdominal 
ring  to  the  globus  minor  of  the  epididymis,  and  is  about  4  inches  long.  It 
consists  of  the  following-named  10  structures,  bound  together  by  areolar  tissue 
and  invested  by  its  coverings.     These  structures  are  the — 

Vas  Deferens.     ^  Fig.  91.  Spermatic  Plexus  of  Nerves. 

Spermatic  Artery ?■  Branch  of  the  Ilio- inguinal  Nerve. 

Cremasteric  Artery.  Branch  of  the  Genito-crural  Nerve. 

Artery  of  the  Vas  Deferens.^  Vasculum  Aberrans. 

Spermatic  Veins.  Lymphatics. 

What  is  the  Pampiniform  Plexus  ?  A  venous  plexus  formed  by  the 
spermatic  veins  and  branches  from  the  epididymis.  It  forms  the  chief  mass 
of  the  spermatic  cord,  and  unites  into  a  single  trunk,  which  on  the  right  side 
empties  into  the  inferior  vena  cava,  On  the  left  side  into  the  left  renal  vein. 

Describe  the  Vesiculae  Seminales.  They  are  two  sacculated,  membra- 
nous pouches,  serving  as  reservoirs  for  the  semen,  and  are  filled  by  the  back- 
ing up  of  that  fluid  from  the  vasa  deferentia.  They  are  about  2}4,  inches  in 
length,  and  are  situated  between  the  base  of  the  bladder  and  the  rectum. 
Their— 

Ejaculatory  Ducts, — one  on  each  side,  are  formed  by  the  junction  of  the 
vasa  deferentia  with  the  ducts  of  the  vesiculae  seminales.  They  are  about 
^  inch  in  length,  and  terminate  in  the  prostatic  portion  of  the  urethra,  by 
orifices  on  the  sides  of  the  veru  montanum. 

Describe  the  Descent  of  the  Testes.  In  early  foetal  life  the  testes  are 
situated  in  the  abdominal  cavity,  just  below  and  in  front  of  the  kidneys,  and 
are  each  connected  to  the  dartos  of  the  scrotum  and  the  tissues  about  the  in- 
guinal canal  by  the  3  processes  of  a  cord  named  the  Gubernaculuju  TestiSy 
which  is  supposed  to  gradually  shorten  itself  and  draw  the  testis  down.  At 
the  beginning  of  the  5th  month  the  descent  begins;  during  the  7th  month  the 
testicle  enters  the  inguinal  canal,  and  ordinarily  arrives  in  the  scrotum  by  the 
end  of  the  8th  month.  A  process  of  peritoneum  is  supposed  to  be  carried 
down  in  front  of  the  testis ;  which  process,  by  obliteration  of  the  canal,  be- 
comes a  separate  structure,  the  Tunica  Vaginalis.  The  structures  of  the 
inguinal  canal  are  also  supposed  to  be  brought  down  vi^ith  the  testicle,  and 
to  constitute  some  of  its  coverings. 


THE  VULVA.  187 

FEMALE  ORGANS  OF  GENERATION. 
THE  VULVA. 

Enumerate  the  Organs  comprised  in  the  Vulva.  They  are  the  Mons 
Veneris,  the  Labia  Majora,  Labia  Minora,  Clitoris,  Meatus  Urinarius,  and  the 
Orifice  of  the  Vagina. 

Describe  the  Labia  Majora.  They  are  two  prominent  folds  formed  of 
skin,  mucous  membrane,  areolar  and  dartoid  tissues; — are  joined  together  at 
the  mons  veneris,  forming  the  Anterior  Commissure^  and  also  in  front  of  the 
perineum,  where  they  form  the  Posterior  Commissure. 

What  are  the  Labia  Minora  ?  The  Labia  Minora  or  Nymphae  are  two 
folds  of  mucous  membrane,  lost  posteriorly  in  the  labia  majora,  but  anteriorly 
they  vjmbrace  the  clitoris,  forming  the  Prepuce  of  that  organ. 

Dt?«cribe  the  other  Parts  comprised  in  the  Vulva.     The — 

Mons  Veneris, — is  the  eminence  in  front  of  the  pubes.  It  is  formed  of  adi- 
pose tissue,  and  at  puberty  becomes  covered  with  hair. 

Clitoris,'^ — is   situated   beneath   the    anterior  Fig.  93. 

commissure,  its  Glans  only  appearing  as  a 
small  rounded  tubercle  between  the  anterior 
extremities  of  the  labia  minora.  It  is  a 
diminutive  penis  in  all  but  the  urethra,  hav- 
ing a  body,  two  crura,  a  glans,  prepuce, 
suspensory  ligament  and  muscles,  the  erec- 
tores  clitoridis. 

Bulbi  Vestibuli,^ — are  two  oblong  masses  extending  from  the  clitoris  along 
the  sides  of  the  vestibule,  and  consisting  of  a  venous  plexus  surrounded  by 
a  fibrous  membrane. 

Pars  Intermedia, — is  a  small  venous  plexus  situated  between  the  glans  clito- 
ridis and  the  bulbi  vestibuli. 

Vestibule, — is  a  triangular  depression  in  front  of  the  vaginal  orifice,  bounded 
laterally  by  the  labia  minora. 

Meatus  Urinarius, "^ — situated  in  the  vestibule,  about  an  inch  below  the  cli- 
toris, and  close  to  the  vaginal  orifice. 

Orifice  of  the  Vagina,"^ — is  surrounded  by  the  sphincter  vaginae  muscle,  and 
in  the  virgin  is  sometimes  partly  closed  by  the  hymen. 

Hymen, — a  fold  of  mucous  membrane  situated  across  the  lower  part  of  tbe 
vaginal  orifice,  of  various  shapes,  but  usually  semilunar,  the  concavity 
upwards.  It  is  frequently  absent  in  virgins,  and  after  sexual  intercourse  its 
rupture  and  cicatrization  give  rise  to  small  eminences  along  the  margin  of 
the  vaginal  orifice,  named  the  Carunculce  Myrtiformes. 


188  VISCERAL   ANATOMY. 

Fourchett^^—z  small  transverse  fold  just  behind  the  posterior  margin  of  the 
vaginal  orifice. 

Fossa  Navicularis, — the  space  between  the  fourchette  and  the  posterior  com- 
missure of  the  vulva. 

Glands  of  Bartholine, — one  on  each  side  of  the  vaginal  orifice,  their  ducts 
opening  on  the  inner  sides  of  the  labia  minora.  They  are  the  analogues  of 
Cowper's  glands  in  the  male. 

THE  VAGINA. 
Describe  the  Vagina.  It  is  a  curved  canal  extending  from  the  vulva  to 
the  uterus,  placed  between  the  bladder  and  the  rectum.  Its  length  is  about  4 
inches  along  its  anterior  wall,  an  inch  longer  posteriorly,  and  its  walls  are 
usually  in  contact  with  each  other.  It  is  very  dilatable,  especially  at  its  upper 
part. 

Describe  its  Structure.  The  vaginal  wall  consists  of  a  muscular  coat 
externally,  a  layer  of  erectile  tissue,  and  a  mucous  lining  covered  with  squa- 
mous epithelium,  and  furnished  with  mucous  glands  and  follicles.     The — 

Columns  of  the  Vagina, — are  two  longitudinal  raphes  situated  along  its 
mucous  surface,  connected  by  numerous  transverse  ridges,  or  RugcB. 

What  are  the  Relations  of  the  Vagina  ?     They  are — 
Anteriorly^ — the  urethra  and  the  base  of  the  bladder. 
Posteriorly^ — the  anterior  wall  of  the  rectum,  and  the  recto-uterine  fold  of 

peritoneum  which  forms  Douglas^  cul-de-sac  behind  its  upper  fourth. 
Laterally, — are  attached  the  broad  ligaments  of  the  uterus,  the  levatores  ani 

muscles,  and  the  recto- vesical  fascia. 
Stiperiorly, — it  is  attached  to  the  cervix  uteri  above  the  os,  and  higher  on  the 

posterior  wall  than  anteriorly. 

THE  UTERUS  AND  ITS  APPENDAGES. 

Where  is  the  Uterus  situated  ?  In  the  pelvic  cavity,  between  the  bladder 
and  the  rectum,  and  above  the  vagina. 

Describe  the  Uterus.  It  is  a  hollow,  pear-shaped,  muscular  organ,  meas- 
uring about  3  inches  long,  2  inches  broad,  and  T  inch  thick,  flattened  from 
before  backwards,  placed  base  upwards,  and  forming  an  angle  with  the  vagina, 
which  partially  receives  its  cervix.     The — 

Fundus,^ — is  broad,  convex,  having  walls  ^  inch  thick,  and  is  covered  by 

peritoneum. 
Body, — is  about  i  j^  inch  long,  walls  j4  inch  thick,  flat  anteriorly,  convex 
posteriorly,  concave  laterally,  and  joined  to  the  bladder  by  its  lower  ante- 


THE  UTERUS   AND  ITS  -APPENDAGES.  189 

rior  fourth.     It  is  invested  by  peritoneum  posteriorly,  and  in  front  for  its 
upper  three- fourths. 

Cervix,  or  Neck^ — is  the  lower  constricted  portion,  about  i^  inch  long, 
walls  ]^  inch  in  thickness,  and  is  embraced  for  }4  ^^  ^  inch  by  the  upper 
extremity  of  the  vagina. 

Cavity  of  the  Body^B — is  small  and  Uriangular,  flattened  from  before  back- 
wards, about  I  y%  inch  in  length,  and  has  two  lateral  Cornua  above,  and 
a  constricted  orifice — the  Os  Internum  Uteri — at  its  lower  angle,  opening 
into  the  cavity  of  the  cervix. 

Cavity  of  the  Cervix, — is  spindle-shaped,  about  l^  inch  long,  and  presents 
on  its  inner  surface  transverse  folds  of  mucous  membrane  proceeding  from 
a  longitudinal  fold,  giving  an  appearance  named  the  Arbor  Vitae.*' 

Os  Uteri  or  Os  Tincte^ — is  a  transverse  orifice  at  the  lower  jsnd  of  the 
cervical  cavity,  opening  into  the  vagina,  and  having  an  anterior  and  a 
posterior  lip. 

Fig.  94. 


I         S 


Enumerate  the  Ligaments  of  the  Uterus.  The  proper  ligaments  of 
the  uterus  are  6  in  number, — 2  Anterior,  or  Utero-vesico-pubic,  2  Posterior,  or 
Utero-recto-sacral,  and  2  Lateral,  or  Broad  Ligaments,  all  composed  of  peri- 
toneum.    The — 

Broad  Ligaments,— ^a&s  from  the  sides  of  the  uterus  to  the  lateral  walls 

of  the  pelvis,  and  form  a  septum  across  the  pelvic  cavity.     They  contain, 

between  the  two  folds  of  peritoneum  of  which  they  are  composed,  the 

Fallopian  tubes,  the  Ovaries,  and  the  so-called  Round  Ligaments. 

What  are  the  Round  Ligaments  of  the  Uterus  ?     They  are  two  cords, 

composed  of  areolar  and  fibrous  tissue,  muscular  fibres,  vessels  and  nerves, 

extending  one  on  each  side,  from  the  lateral  aspects  of  the  fundus  uteri,  through 

the  inguinal  canals,  to  the  labia  majora,  where  they  are  lost.     Each  ligament 

lies,  for  a  part  of  its  course,  between  the  two  layers  of  the  broad  ligament,  and 

is  covered  by  a  process  of  peritoneum.     (^  Fig.  94.) 


190  VISCERAL   ANATOMY. 

Canal  of  Nuck^ — is  the  extension  of  the  above-named  process  of  perito- 
neum into  the  inguinal  canal.  It  exists  in  the  foetus,  and  is  usually  ob- 
literated in  the  adult. 

Describe  the  Uterine  Structure.  The  uterine  wall  has  3  coats — perito- 
neal, muscular  and  mucous.     Its — 

Peritoneal  or  Serous  Coal, — invests  the  body  of  the  organ,  excepting  on  its 
lower  anterior  fourth. 

Muscular  Coat, — constitutes  the  chief  bulk  of  the  uterus.  It  consists  of 
bundles  of  unstriped  muscular  fibres,  disposed  in  3  layers  interlaced 
together ;  circular  fibres  predominating  in  the  cervix,  longitudinal  fibres 
in  the  body  of  the  organ. 

Mucous  Coat, — is  very  thick,  -^^  to  ^  inch,  and  closely  adherent  to  the 
rauscufer  tissue,  having  no  basement  layer  of  connective  tissue.  It  is 
covered  with  ciliated  columnar  epithelium,  and  studded  with  mucous 
follicles  and  glands,  which  are  most  numerous  in  the  cervix.  The  latter, 
when  distended  by  their  own  secretions,  form  sacs,  which  Naboth  mistook 
for  human  ova,  and  hence  were  named  the  Ovules  of  Naboth. 

Enumerate  the  Uterine  Vessels  and  Nerves.     ItS' — 

Arteries, — are  the  Uterine,  from  the  anterior  trunk  of  the  external  iliac,  anas- 
tomosing with  twigs  from  the  Ovarian — (spermatic  branch  of  the  abdominal 
aorta). 

Veins, — accompany  the  arteries,  and  in  the  impregnated  state  become  sinuses. 
They  end  in  the  uterine  plexuses. 

Lymphatics, — those  of  the  cervix  end  in  the  sacral  and  internal  iliac  glands, 
those  of  the  fundus  in  the  lumbar  glands. 

Nerves, — are  derived  from  the  inferior  hypogastric  and  ovarian  plexuses,  and 
from  the  3d  and  4th  sacral  nerves. 

Describe  the  Fallopian  Tubes  or  Oviducts.  They  are  two  tubes, 
<ach  about  5  inches  in  length,  and  -^^  inch  in  calibre,  situated  in  the 
free  margin  of  the  broad  ligament,  and  extending  from  the  superior  angles 
of  the  uterus  ^  outwards,  to  terminate  in  free,  trumpet- shaped  ends,  the 
Fimbriated  Extremities,^  surrounded  by  fringe-like  processes,  the  Fimbria;, 
of  which  one  or  more  are  attached  to  the  ovary  of  that  side.  Their  structure 
is  similar  to  that  of  the  uterus,  their  mucous  lining  being  continuous  with 
the  uterine  mucous  membrane  and  with  the  peritoneum.  They  open  by 
one  end  into  the  uterus  at  its  cornua,  by  the  other  end  into  the  peritoneal 
cavity. 

"What  are  the  Ovaries  ?  Two  oval  bodies,-^  of  whitish  color,  situated  in 
the  broad  ligament,  behind  and  below  the  Fallopian  tubes,  one  on  each  side 
of  the  uterus,  to  which  they  are  attached  by  the  Ligaments  of  the  Ovaries.^ 


THE  UTERUS   AND   ITS  APPENDAGES.  191 

They  each  measure  about  i  %  inch  by  ^  by  ^,  and  are  invested  by  perito- 
neum, except  posteriorly. 

Describe  the  Structure  of  the  Ovaries.  They  are  composed  of  a  vas- 
cular stroma  containing  the  Graafian  Vesicles  or  Ovisacs^  in  various  stages  of 
development,  and  are  surrounded  by  a  dense  fibrous  coat,  the  Tunica  Albu- 
ginea. 

Describe  the  Graafian  Vesicles.  They  are  the  ovisacs  containing  the 
human  ova,  are  very  numerous  (about  70,000  in  each  ovary),  vary  in  diameter 
from  -^^  to  ^-^  inch,  but  after  puberty  a  few  are  found  of  from  -^^  to  \  inch  ot 
more.     Each  vesicle  presents  an — 

External  Coat, — of  fibro-vascular  structure. 
Ovi-capsule, — or  internal  coat. 

Membrana  Granulosa, — a  layer  of  nucleated  cells,  which  at  one  point  are 
heaped  up  around  the  ovum  in  a  mature  vesicle,  forming  the  Discus  Pro- 
ligerus. 
Fluid, — of  transparent,  albuminous  character,  containing  the  ovum  in  imma- 
ture vesicles. 

What  is  the  Ovum  ?  It  is  a  spherical  mass  of  protoplasm,  about  j|^^ 
inch  in  diameter  when  fully  developed.     It  presents  a — 

Vitelline  Membrane, — also  called  the  Zona  Pellucida, — a  colorless  envelope, 

in  which  i^  contained  the — 
Vitellus  or  Yelk, — composed  of  granules  in  a  fluid  substance,  one  of  which 

is  called  the — 
Ger?ninal  Vesicle, — which  contains  a  smaller  body  named   the  Ger*ninal 

Spot,  measuring  about  the  j-^q-j^  of  an  inch  in  diameter. 

What  is  the  Corpus  Luteum  ?  It  is  a  puckered  yellow  spot  in  the  sub- 
stance of  the  ovary,  produced  as  a  result  of  the  rupture  of  a  Graafian  vesicle 
and  the  discharge  of  an  ovum,  probably  by  the  fatty  degeneration  of  the  ex- 
travasated  blood.     The — 

True  Corpus  Luteum, — is  that  of  pregnancy,  and  may  increase  in  size,  not 

disappearing  until  full  term. 
False  Corpus  Luteum, — occurs  when  impregnation  has  not  taken  place,  and 
is  absorbed  in  about  three  months. 

What  is  the  Pampiniform  Plexus  ?  A  venous  plexus  near  the  ovary, 
formed  by  the  veins  of  that  organ. 

Enumerate  the  Arteries  and  Nerves  of  the  Ovaries.     Their — 
Arteries, — are  the  Ovarian  (or  Spermatic),  from  the  aorta,  which  also  supply 

the  Fallopian  tubes,  anastomosing  with  the  uterine  arteries. 
Nerves, — are  derived  from  the  Spermatic  plexus. 


192 


VISCERAL  ANATOMY. 


What  is  the  Parovarium  ?  The  Parovarium,  or  Organ  of  Rosentnuller, 
is  a  group  of  tubules,  situated  in  the  broad  ligament,  between  the  ovary  and 
the  Fallopian  tube,  and  converging  to  a  large  duct,  the  Duct  of  Gartner, 
which  ramifies  in  the  broad  ligament,  and  descends  along  the  side  of  the 
uterus.  It  is  thought  to  be  a  remnant  of  the  Wolffian  Body  of  foetal  life. 
(See  "Reproduction,"  in  Compend  of  Physiology.) 


THE  MAMMJE. 


Describe  the  Mammse. 

Fig.  95. 


The  breasts  are  two  hemispherical  eminences, 
situated  one  on  each  latero-anterior  aspect  of 
the  chest,  extending  from  the  sternum  to  the 
axilla,  and  from  the  3d  rib  to  the  7th.  Each 
breast  contains  the  Alammary  Gland  ?^nd  is 
surmounted  by  the  Nipple,  around  the  base  of 
which  is  a  zone  of  colored  cutaneous  tissue, 
the  Areola,  pink  in  virgins,  darker  in  women 
who  have  borne  children.  In  the  male  the 
mammae  are  rudimentary  organs,  but  capable 
of  development  under  special  circumstances. 

Describe  the  Structure  of  the  Mam- 
mary Gland.  It  is  a  compound  conglomer- 
ate gland,  composed  of  15  or*  20  lobes  and 
their  ducts,  ^  with  a  packing  of  areolar  and 
iji'!'  adipose  tissue,  and  enveloped  by  a  fibrous 
capsule  which  forms  septa  between  the  lobes. 
Each  lobe  is  made  up  of  lobules, 2  and  these 
again  are  formed  by  the  aggregation  of  the 
Acini  or  terminal  vesicles,  in  which  the  milk 
is  secreted.  The  — 
Tubuli  Lactiferi  or  Tubuli  Galactophori,^ — are  the  excretory  ducts  of  the 
lobes,  one  for  each.  They  are  formed  by  the  junction  of  the  ducts  from 
each  lobule,  and  converge  towards  the  areola,  beneath  which  they  form 
AmpullcE  or  dilatations,  and  thence,  piercing  the  nipple,  open  on  its  sum- 
mit by  separate  orifices. 

What  is  the  Circulus  Venosus  ?  An  anastomotic  venous  circle  around 
<he  base  of  the  nipple,  from  which  larger  veins  run  outwards  and  terminate  in 
the  axillary  and  internal  mammary  veins. 

Name  the  Arteries  of  the  Mammae.  They  are  derived  from  the  Tho- 
racic Branches  of  the  axillary,  the  Intercostals,  and  the  Internal  Mammary 
arteries. 


THE  SKIN   AND   ITS   APPENDAGES. 


198 


Epidermis,  or  Cuticle, 


Derma,  or  Cutis  Vera 
the  True  Skin. 


THE  ORGANS  OF  SENSE. 
THE  SKIN  AND  ITS  APPENDAGES. 
Name  the  Divisions  of  the  Skin.     It  is  divided  into  the — 
r  Superficial  EpitheHal  layers. 
t  Rete  Mucosum,  the  pigmentary  layers. 

Papillary  Layer,c  next  below  the  rete,  from  which 
it   is   separated   by   a    homogeneous    basement 
I        membrane. 
I    Corium,d  the  deepest  portion. 

What  Structures  lie  in  and  beneath  the  Skin  ?     The 

Sensitive  Papillce,  containing  the  Tactile  Corpuscles  in  very  sensitive  parts, — 

in  the  papillary  layer  of  the  Derma. 

Sweat-glands./, i:-         Hair-roots. h>i  ^    .^    ^  ,       .  ^  ,.  ,      ^. 

^,      ,   .        ^     ^„         V  In  the  Sub- cutaneous  Cellular  Tissue. 
Sebaceous  Glands.*        Fat  Cells.'     J 

Ducts  of  the  Sweat-glands. 
Hair-follicles, — into  which  most  of  the  seba- 
ceous ducts  open. 
Ducts  of  the  Sebaceous  Glands, — occasionally. 

Describe  the  Structure  of  the  Epidermis.  It  is  an  unorganized  epithe- 
lial structure,  having  no  vessels  or  nerves.  The  cells  of  which  it  is  composed 
are  agglutinated  together  in  a  lami- 


Perforate   both  the  Dermfl 
and  the  Epidermis. 


nated  arrangement,  are  flat  and  dry 
on  the  surface,  round  and  softer  in  the 
central  portion,  columnar  and  softest 
in  the  deepest    layers.     The   lowest 
and  softest  layers  are  named  the — 
Rete  Mucosum, — which   is  closely 
moulded  upon  the  papillary  layer 
of  the  derma,  and  contains  pig- 
ment cells,  to  which  the  color  of 
the  skin  is  due. 
Describe  the  Structure  of  the 
Derma.     The  true  skin  is  a  highly 
organized,  tough  yet  elastic  tissue,  and 
serves  to  protect  the  parts  beneath,  to 
perform  the  functions  of  excretion  and 
absorption,  and  as  the  chief  seat  of  the 
sense  of  touch.  It  consists  of  fibro-areo- 
Ur  tissue,  vessels  and  nerves.    The — 


Fig.  96. 


194  VISCERAL  ANATOMY. 

Papillary  Layer, — situated  next  to  the  rete  mucosum,  is  covered  with  minute 
conical  elevations  (papillae),  ■^\-^  inch  high  ^\-^  inch  in  diameter  at  their 
base,  very  numerous  and  arranged  in  parallel  curved  lines  wherever  sen- 
sibility is  greatest.     Each  papilla  contains  a  capillary  loop  or  plexus,  the 
termination  of  one  or  more  sensory  nerves, — and  in  highly  sensitive  parts, 
an  oval  shaped  body,  the  Tactile  Corpuscle. 
Corium, — the  lower  layer  of  the  derma,  is  composed  chiefly  of  interlacing 
bundles  of  white  fibrous  tissue,  in  which  are  mingled  some  yellow  elastic 
fibres,  also  plain  muscular  fibres  wherever  hairs  are  found, — and  lym- 
phatic vessels,  blood-vessels  and  nerves,  in  plexiform  arrangement. 
Describe  the  Nails.     They  are  flat,  horny  structures,  a  modification  of 
the  epidermis,  molded  upon  the  derma  at  the  dorsal  surface  of  the  terminal 
phalanges  of  both  fingers  and  toes.     Each  nail  is  convex  on  its   outward 
surface,  and  is  imbedded  by  its  Root  into  a  fold  of  the  skin.     Its — 

Matrix, — is  that  portion  of  the  derma  directly  beneath  the  nail.     It  is 

covered  with  highly  vascular  papillae.     The — 
Lunula, — is  a  white  crescentic  portion  of  the  nail  nearest  to  its  root,  pro- 
duced by  the  diminution  in  number  and  size  of  the  papillae  beneath. 

What  are  the  Hairs  ?  They  are  also  a  modified  form  of  the  epidermis, 
found  over  nearly  the  whole  surface  of  the  body,  much  varied  in  size  and 
color.     Each  hair  consists  of  a  Root  and  a  Shaft.     The — 

Root, — is  lodged  in  an  involution  of  the  epidermis  called  the  Hair-follicle, 
which  sometimes  extends  into  the  subcutaneous  cellular  tissue.  The  root 
rests  on  a  vascular  papilla  at  the  bottom  or  Bulb  of  the  follicle,  which 
supplies  it  with  the  material  for  its  growth. 
Shaft, — is  the  projecting  portion  of  the  hair.  It  consists  of  a  medulla  in 
the  centre,  next  a  fibrous  portion,  externally  a  cortex  of  thin,  flat  scales. 
The  finest  hairs  have  no  medulla. 
/*(?/■«/,— consists  of  the  fibrous  portion  and  the  cortex,  the  medulla  being 

wanting. 
Where  are  the  Sebaceous  Glands  most  abundant  7    In  the  scalp,  the 
face,  around  the  anus,  and  the  apertures  of  the  nose,  mouth  and  external  ear. 
The  largest  are  the — 

Meibomian  Glands, — situated  in  the  eyelids  (see  Fig.  104). 

Describe  the  Sebaceous  Glands.  They  are  small,  glandular  bodies 
situated  in  the  corium  or  in  the  subcutaneous  cellular  tissue  over  most  of  the 
body,  but  not  in  that  of  the  palmar  surface  of  the  hands  nor  on  the  plantar 
surface  of  the  feet.  Each  gland  consists  of  a  single  sacculated  duct,  usually 
opening  into  a  hair  follicle,  but  sometimes  ending  on  the  surface  of  the  in* 
tegument. 


THE  NOSE.  19^ 

Describe  the  Sweat-glands.  Ench  gland  consists  of  a  single  convoluted 
tube,  situated  usually  in  the  subcutaneous  cellular  tissue,  and  opening  on  the 
surface  of  the  integument  by  a  spiral  duct  which  pierces  the  derma  and  the 
epidermis.  It  is  formed  of  two  coats,  an  external  fibro -cellular,  which  is  con- 
tinuous with  the  corium,  and  an  epithelial  lining,  continuous  with  the  epidermis. 

State  the  probable  number  of  Sweat-glands  and  their  Evaporating 
area.  They  are  estimated  as  varying,  in  different  parts  of  the  integument, 
from  417  to  2800  to  the  square  inch,  giving  for  the  whole  body  a  total  of 
nearly  two  millions  and  a  half,  representing  an  evaporating  surface  of  about  8 
square  inches. 

ORGANS  OF  TASTE. 

What  are  the  special  Organs  of  Taste  ?  The  Taste-buds,  small,  flask- 
shaped  bodies,  each  about  3^^  inch  long,  situated  in  the  fungiform  and  cir- 
cumvallate  papillae  of  the  tongue.  The  seat  of  the  sense  of  taste  lies,  how- 
ever, in  the  mucous  membrane  covering  the  dorsum  of  the  tongue,  the  upper 
portion  of  the  pharynx,  the  soft  palate  and  the  fauces. 

Name  the  special  Nerves  of  Taste  in  the  Tongue.     The — 
Chorda  Tytnpani  Branch  of  the  Facial, — for  its  anterior  two-thirds;  perceiv- 
ing saline,  acid  and  styptic  qualities  (Flint). 
Lingual  Branch  of  the  Glosso-pharyngeal, — for  its  posterior  third;  apprecia- 
ting  alkaline,  metallic,  sweet  and  bitter  tastes  (Flint). 

What  is  Sapolini's  view  of  the  Chorda  Tympani  Nerve  ">  From  re- 
peated dissections.  Dr.  Sapolini,  of  Milan,  believes  the  chorda  tympani  to  be  a 
separate  cranial  nerve,  having  its  proximal  end  in  the  so-called  intermediary 
nerve  of  Wrisberg,  originating  in  the  floor  of  the  4th  ventricle,  and  termina- 
ting in  a  dense  plexus  with  the  lingual  branch  of  the  5th  nerve,  in  the  mus- 
cles of  the  tongue.  He  further  concludes  that  the  chorda  tympani  is  the  nerve 
governing  the  movements  of  the  tongue  in  speech,  and  that  the  nerves  of  taste 
are  the  Lingual  Branches  of  the  5th  and  9th  nerves. 

THE  NOSE. 

[For  an  osteological  description  of  the  Nasal  Fossae  and  Septum,  see  page  31.] 
Where  is  the  Organ  of  Smell  situated  ?  In  the  mucous  lining  of  the 
upper  portion  of  the  nasal  fossae,  which  is  the  seat  of  distribution  of  the  ter- 
minal filaments'^  of  the  Olfactory  Nerve,d  the  special  nerve  of  the  sense  of 
smell. 

What  is  the  Schneiderian  Membrane  ">  The  Schneiderian  or  Pituitary 
Membrane  is  the  mucous  membrane  of  the  nasal  fossae.     It  is  continuous  with 


196 


VISCERAL  ANATOMY. 


the  mucous  lining  of  the  pharynx,  Eustachian  tube,  tympanum  and  mastoid 
cells;  also  with  that  of  the  frontal,^  ethmoidal  and  sphenoidal  sinuseSj-^  the 
antrum,  nasal  duct,  and  the  conjunctiva.  It  is  covered  with  columnar  epithe- 
lium, ciliated  throughout  most  of  its  extent,  provided  with  mucous  glands,  and  in 
YiQ  97,  ^'^^  deeper  layer  with  the — 

J  Olfactory  Cells  ofSchullze, 

—  spindle-shaped,  epi- 
thelial structures  grouped 
around  and  between  the 
columnar  epithelial  cells, 
and  joined  together  by 
their  anastomosing  pro- 
cesses, to  form  an  intri- 
cate plexus  on  which  the 
terminal  fibres  of  the  ol- 
factory nerve  are  sup- 
posed to  be  distributed. 

Name  the  Arteries  of  the  Nose.     They  are  the — 
Lateralis  JVasi, — branch  of  the  facial,  to  the  alae  of  the  nose. 
Nasal  of  the  Septum, — from  the  superior  coronary  artery,  to  the  septum. 
Nasal, — branches  of  the  ophthalmic  and  infra- orbital,  to  the  dorsum  and  sides 

of  the  nose. 

Name  the  Arteries  of  the  Nasal  Fossae.     They  are  the — 
Anterior  and  Posterior  Ethmoidal, — from  the  ophthalmic. 
Spheno-palatine, — branch  of  the  internal  maxillary. 
Alveolar, — branch  of  the  internal  maxillary,  to  the  antrum. 

What  Nerves  supply  the  Nose  ?  Branches  from  the  facial,  infra- 
orbital and  infra-trochlear,  and  a  filament  from  the  nasal  branch  of  the 
ophthalmic  nerve. 

What  Nerves  supply  the  Nasal  Fossae  ?     They  are  the — 

Olfactory  or  jst  Cranial,e — over  the  upper  third  of  the  septum  nasi,  And  over 
the  superior  and  middle  turbinated  bones. 

Nasal  Branch  of  the  Ophthalmic,  S — to  the  septum  and  outer  walls. 

Anterior  Dental  Branch  of  the  Superior  Maxillary,  J— io  the  inferior  meatus 
of  the  nose  and  the  inferior  turbinated  bone. 

Sphenopalatine  Ganglion, — sends  branches  to  the  septum  and  the  superior 
turbinated  bone, — the  Superior  Nasal  Br.  to  the  same  parts,— the  Naso- 
palatine to  the  middle  of  the  septum, — and  the  Anterior  Palatine  to  the 
middle  and  lower  turbinated  bones. 


THE   EYE.  197 

THE  EYE. 

[For  an  osteological  description  of  the  Orbit,  see  page  29.] 
What  is  the  Visual  Apparatus  ?     It  comprises  the  eyeballs  and  their 
appendages,  which  collect  the  luminous  impressions, — and  the  optic  nerves, 
which  convey  these  impressions  to  the  brain. 

Describe  the  Eyeball.  It  is  a  spherical  organ,  situated  in  the  anterior 
part  of  the  orbital  cavity,  on  a  cushion  of  connective  tissue  and  fat,  where  it  is 
retained  by  its  muscles,  the  optic  nerve,  the  conjunctiva,  etc.,  and  protected  in 
front  by  the  eyelids  and  eyebrows.  Projecting  from  its  anterior  surface  is  the 
segment  of  a  smaller,  transparent  sphere,  the  Cornea.  The  eyeball  has  the 
following — 

Diameters, — Antero-posterior,   about    .95   inch, — Transverse,   .92   inch, — 

Vertical,  .90  inch, — in  the  adult. 
Anterior  Fole,—'\s  the  geometric  centre  of  the  cornea. 
Posterior  Pole, — is  the  geometric  centre  of  the  fundus. 
Optic  Axis, — is  an  imaginary  straight  line  connecting  the  poles. 
Visual  Axis, — an  imaginary  straight  line  from  the  yellow  spot  to  the  object, 
through  the  nodal  point.     It  cuts  the  cornea  above  the  optic  axis,  at  an 
angle  therewith  of  3°  to  7°,  the  Visual  Angle. 
Nodal  Point, — the  centre  of  curvature  of  the  refracting  surfaces. 
Equatorial  Plane, — an  imaginary  plane  through  the  centre  of  the  eyeball, 
perpendicular  to  the  axis,  dividing  the  ball  or  globe  into  the  anterior  and 
posterior  hemispheres.     The  Equator  is  the  line  where  this  plane  cuts  th^ 
surface  of  the  globe. 
Meridional  Planes, — are  imaginary  planes  coinciding  with  the  axis  of  the 
eyeball.     Meridians  are  the  lines  where  these  planes  intersect  the  surface 
of  the  globe. 

Describe  the  Tunica  Vaginalis  Oculi.  It  is  a  fibrous  capsule,  sur- 
rounding the  eyeball  and  the  intra -orbital  portion  of  the  optic  nerve ;  arising 
from  the  optic  foramen  and  being  lost  anteriorly  on  the  sclerotic.  It  consists 
of  two  layers  (parietal  and  visceral)  enclosing  a  lymph-space  which  communi- 
cates with  the  lymph- space  between  the  sclerotic  and  choroid  coats.  The 
tendons  of  the  ocular  muscles  pierce  it.     The — 

Capsule  of  Bonnet, — is  the  portion  of  tunica  vaginalis  posterior  to  the  point 
where  the  tendons  pass  through  it.  This  part  is  loosely  attached  to  the 
eyeball,  which  rotates  in  it. 
Capsule  of  Tenon, — is  the  portion  of  the  tunica  vaginalis  anterior  to  the 
passage  of  the  tendons.  [The  whole  capsule  or  Tunica  Vaginalis  is  by 
many  anatomists  named  the  Capsule  of  Tenon.] 


198 


VISCERAL  ANATOMY. 


Name  the  Tunics  of  the  Eyeball. 
They  number  3,  and  are  named  as  fol 
lows:  the — 

Sclerotic  '  and  Cornea,'^ — the  exter- 
nal and  protective  tunic. 
Uveal  Tract, — or  vascular  tunic, 
comprising  the  Choroid,*  Ciliary 
body  and  the  Iris,^  within  which 
is  the — 
Retina,^'^ — the    innermost,   nervous 

tunic. 
Name  the  Humors  of  the  Eyeball. 
They  also  number  3,  as  follows  : — 

Aqueous,"^ — in  the  anterior  2  and 

middle  ^  chambers. 
Crystalline,  — iorramg  the  crystal- 
line lens.  1 5 
Vitreous y'^^ — in  the  posterior  chamber  of  the  eyeball. 

The  Sclerotic  and  Cornea. 
Describe  the  Sclerotic.  The  Sclerotic  or  hard  coat  is  the  posterior  five- 
sixths  of  the  external  tunic  of  the  eyeball,  the  anterior  one-sixth  being  the 
Cornea.  Externally  it  is  of  a  white  color,  covered  anteriorly  by  the  conjunc- 
tival mucous  membrane,  posteriorly  being  continuous  with  the  sheath  of  the 
optic  nerve.  Internally  its  color  is  brown,  and  its  surface  marked  by  grooves 
for  the  ciliary  nerves.  The  optic  nerve  pierces  it  posteriorly,  also  the  long  and 
short  ciliary  arteries,  posterior  ciliary  veins  and  short  ciliary  nerves.  In  the 
equatorial  region  it  is  pierced  obliquely  by  the  venae  vorticosae,  and  around  the 
corneal  border  by  the  anterior  ciliary  arteries  and  veins.  It  is  composed  oi 
connective  tissue  with  elastic  fibres,  intermixed  with  pigment  cells,  and  cells 
resembling  the  corneal  corpuscles.  It  presents  for  consideration  the  following 
points,  viz. : — 

Thickness, — ^^^  inch  posteriorly,  -^^  inch  anteriorly. 

Lamina  Fusca, — a  layer  of   very  fine   connective  tissue,  connecting  the 

sclerotic  with  the  outer  surface  of  the  choroid. 
Lamina  Cribosa, — the  posterior  perforated  portion  of  the  sclerotic,  which 
at  this  point  is  a  thin,  cribriform  lamina.  Its  largest  opening  transmits 
the  arteria  centralis  retinae,  and  is  named  the  Porus  Opticus,  or  Optic 
Canal. 
Sub-conjunctival  Tissue, — connects  the  conjunctiva  with  the  outer  surface 
of  the  sclerotic. 


THE  CORNEA.  199 

Sulcus, — a  slight  circular  depression  around  the  junction  of  the  sclerotic 
with  the  cornea. 

Arteries, — from  the  Ciliary,  are  few  and  in  a  coarse  net- work,  uniting  at 
wide  intervals,  but  forming,  however,  the — 

Posterior  Vascular  Zone,  or  Zone  of  Zinn, — an  arterial  zone  around  the 
optic  nerve  entrance,  formed  by  twigs  of  the  short  ciliary  going  to  the 
optic  nerve  to  anastomose  with  branches  of  the  central  artery  of  the  retina, 
forming  the  only  connection  between  the  cihary  and  retinal  systems. 

Anterior  Vascular  Zone, — around  the  cornea,  formed  by  sub- conjunctival 
branches  of  anterior  ciliary  vessels. 

Nerves, — none  have  been  yet  found  in  the  sclerotic. 

What  is  the  Cornea  ?  The  Cornea,  or  horny  body,  is  the  anterior  trans- 
parent projecting  portion  of  the  external  tunic  of  the  eyeball,  forming  about 
one-sixth  thereof.  It  is  set  into  the  sclerotic  as  a  watch-crystal  into  its  case,  is 
of  ellipsoidal  base,  the  transverse  diameter  being  the  longest,  and  slightly 
more  convex  vertically  than  horizontally.     Its — 

Thickness, — is  ^^  inch  at  centre,  ^^  inch  at  periphery. 
Index  of  Refraction,—  i  .■^^2. 

Vessels, — none,  except  the  peripheral  zone,  ^^  inch  wide,  formed  of  capil- 
lary loops  from  Episcleral  branches  of  the  anterior  ciliary,  which  termi- 
nate at  its  circumference  ;  so  that  it  is  practically  a  non-vascular  structure. 
Nerves, — are  numerous ;  20  or  30  twigs  from  the  Ciliary  nerves  form  an 
intricate  plexus  throughout  its  laminated  substance. 

Describe  the  Structure  of  the  Cornea.  It  consists  of  five  layers, — cen- 
trally the  true  corneal  tissue,  having  in  front  an  anterior  elastic  lamina  and  the 
conjunctival  epithelium ;  behind,  a  posterior  elastic  lamina  and  the  epithelial 
lining  of  the  aqueous  chamber.     The — 

Layer  of  Conjunctival  Epithelium  -g\-^  inch  thick,  consists  of  two  or  three 
layers  of  transparent  nucleated  cells. 

Anterior  Elastic  Lamina,  also  named  the  Anterior  Limiting  Layer,  the 
Membrane  of  Bowman  or  Membrane  of  Reichert, — is  -^^'^^  to  ^J^^  inch 
thick,  a  firm,  elastic  and  transparent  homogeneous  membrane,  consisting 
of  closely-interwoven  fibrils,  similar  to  those  in  the  corneal  tissue  proper. 

True  Corneal  Tissue, — -^^  inch  thick,  a  transparent,  fibrous  structure,  formed 
of  five  connective-tissue  fibrillae,  united  in  bundles,  and  these  in  laminae, 
between  which  is  a  semi-fluid  cement,  filled  with  Corneal  Corpuscles  and 
wandering  cells. 

Posterior  Elastic  Lamina,  Membrane  of  Descemet,  or  Demours, — is,  like 
the  anterior  elastic  lamina,  a  structureless  basement  membrane,  of  extreme 
thinness,  resisting  the  action  of  water,  alcohol  or  acids ;  very  brittle,  ex- 


200  VISCERAL  ANATOMY. 

ceedingly  elastic,  and  curls  up  inwardly  upon  itself,  when  detached  from 
the  true  cornea.  At  the  corneal  margin  it  breaks  up  into  fibres,  which  are 
continuous  with  the  ligamentum  peclinatum  of  the  iris. 
Posterior  Epithelial  Layer, — a  single  layer  of  flattened,  polygonal,  trans- 
parent, nucleated  cells,  forming  the  endothelium  of  the  membrane  of 
Descemet  or  Demours,  and  the  epithelial  lining  of  the  aqueous  chamber. 

The  Uveal  Tract. 

Describe  the  Choroid.  It  is  the  posterior  portion  of  the  middle  tunic  of 
the  eyeball,  -^\-q  to  ■^\-^  inch  thick,  and  extends  from  the  optic  nerve  entrance 
to  the  ora  serrata,  a  little  in  front  of  the  equator.  It  is  highly  vascular,  of 
dark- brown  color,  connected  to  the  sclerotic  by  the  Lamina  Fusca,  terminates 
anteriorly  in  the  Ciliary  Processes,  and  is  composed  of  four  layers,  as  follows  : — 
Tunica   Vasculosa, — externally,  consists   of  the   venae  vorticosae   and   the 

larger  arterial  branches. . 
Membrana  Ruyschiana,  or  Chorio-capillaris,  the  middle  layer — consists  of 

a  fine  capillary  plexus,  formed  by  the  short  ciliary  vessels. 
Limiting  Membrane^ — a  structureless  hyaline  membrane,  covering  the  inner 

surface  of  the  capillary  layer. 
Pigmentary  Layer,  internally, — a  single  layer  of  hexagonal  nucleated  cells, 
loaded  with  pigment  of  a  brown  black  color,  which  is  absent  in  albinos, 
and  of  slight  amount  in  blondes.     [Considered  by  many  anatomists  the 
loth  layer  of  the  retina,] 
Arteries  of  the  Choroid, — are  the  short  posterior  ciliar}%  and  recurrent  branches 

from  the  long  posterior  and  anterior  ciliary.     (See  p.  105.) 
Veins, "^ — unite  into  4  or  6  Venae  Vorticosse,*  which  pass  out  through  the 

sclerotic  near  its  equator. 
Nerves,^ — derived  from  3d,  5th,  and  sympathetic,  through  the  long  and  short 
ciliary  nerves.     (See  p.  I37-) 

What  are  the  Ciliary  Processes  ?  They  are  70  or  80  folds,  formed  by 
the  anterior  prolongation  of  the  middle  and  internal  layers  of  the  choroid  on 
the  inner  surface  of  the  ciliary  muscle,  being  received  into  corresponding  folds 
on  the  suspensory  ligament  of  the  lens.  They  are  about  -^^  inch  in  length, 
and  form  a  curtain-like  expansion  behind  the  iris. 

Describe  the  Ciliary  Body.^  It  is  the  portion  of  the  uveal  tract  between 
the  choroid  and  the  iris,^  and  consists  of  ciliary  muscle  covered  by  choroidal 
stroma  and  the  ciliary  processes.     The— 

Ciliary  Muscle  or  Muscle  of  Bowman,— \%  a  ring  of  involuntary  muscular 
fibres,  supphed  by  the  3d  nerve ;  is  thickest  anteriorly,  thin  posteriorly. 
Its  fibres  arise  from  the  corneo-sclerotic  junction,  and  pass  backwards  to 


THE  UVEAL  TRACT. 


201 


be  attached  to  the  choroid  in  front  of  the  retina.    Consists  of  meridional  fibres 
drawing  the  choroid  forwards,  and  circular  fibres  which  relax  the  zonula 
and  permit  the  lens  to  become  more  convex,  from  its  own  elasticity. 
Annular  Muscle  of  Milller, — consists  of  separate  circular  bundles  at  the 

anterior  internal  angle  of  the  ciliary  body. 

Circulus  Arteriosus  Major  and  Minor, — are  arterial  circles  on  the  ciliary 

muscle,  formed   by  branches  of  the   long  posterior  ciliary  and  anterior 

ciliary  arteries. 

What  is  the  Iris  ^  ?     It  is  a  perforated  c.urtain,  suspended  in  the  aqueous 

humor  behind  the  cornea  and  in  front  of  the  lens,  and  is  the  anterior  portion 

of  the  middle  tunic  of  the  eyeball,  being  continuous  with  the  ciliary  muscle 

and  the  choroid  coat.     It  is  about  \  inch  wide,  y^^  inch  thick,  and  is  com- 

FlG.  99. 


posed  of  radiating  and  circular  muscular  fibres,  a  fibrous  stroma  and  pigment 
cells,  covered  by  a  layer  of  irregular  cells  continuous  with  those  of  the  mem- 
brane of  Descemet.     The — 

Pupil, — is  the  central  opening  in  the  iris,  situated  a  little  to  the  nasal  side 

of  the  centre,  diameter  -^^  to  \  inch. 
Ligamentum  Pectinatum  Jridis,  or  Bollinger's  band, — is  the  suspensory 
ligament  of  the  iris,  connecting  its  ciliary  margin  with  the  corneo- sclerotic 
junction.  It  is  formed  of  strong  fibrous  prolongations  firom  the  membrane 
of  Descemet  and  the  posterior  surface  of  the  cornea. 
Fontana^s  Spaces, — are  spaces  between  the  prolongations  which  form  the 
ligamentum  pectinatum.  In  some  animals,  as  the  ox,  they  fornt  regular 
canals. 


202  VISCERAL  ANATOMY. 

Uvea^  or  Tapetum, — a  layer  of  purple  pigment-cells  on  the  posterior  surface 
of  the  iris,  continuous  with  the  pigment  layer  of  the  ciliary  processes. 

Sphincter  Pupilla, — a  layer  of  circular  muscular  fibres  around  the  pupillary 
margin,  supplied  by  the  3d  nerve. 

dilator  Pzipillce, — radiating  muscular  fibres  from  the  pupillary  margin  toward 
^ije  ciliary  border,  supplied  by  fibres  of  the  sympathetic,  from  the  ciliary 
ganglion.     [See  p.  137.] 

Menibrana  Pupillaris, — a  vascular  membrane  which  covers  the  pupil  in 
the  foetus,  disappearing  about  the  eighth  month, — occasionally  permanent. 
It  is  nourished  by  the  Hyaloid  Artery,  through  the  Canal  of  Stilling  (de- 
scribed under  the  Vitreous  Humor). 

Arteries, — are  derived  from  the  long  and  anterior  Ciliary,  forming  the  Cir- 
culus  Major  Iridis  at  the  ciliary  border,  and  the  Circulus  Arteriosus 
Iridis  Minor  near  the  pupillary  margin. 

Veins, — empty  into  those  of  the  ciliary  processes  and  the  anterior  ciliary  veins 

Sinus  Circularis  Iridis,  Canal  of  Schlemm,  or  Canal  of  Fontana, — is  z 
minute  canal  at  the  internal  corneo-sclerotic  junction,  extending  arounc 
the  circumference  of  the  attached  border  of  the  iris.  It  is  lined  by  endo 
thelium  and  encloses  a  venous  plexus,  receiving  veins  from  the  sclerotic 
and  the  ciliary  plexus.  It  communicates  with  the  chamber  of  the  aqueous 
humor  and  with  the  anterior  ciliary  veins. 

Nerves  of  the  Iris, — are  derived  from  the  3d,  5th  and  the  sympathetic, 
through  the  long  and  short  ciliary  nerves.  The  3d  supplies  the  circular 
fibres,  the  sympathetic  the  radiating  ones,  the  5th  being  nerves  of  common 
sensation. 

The  Retina. 

What  is  the  Retina  ?  It  is  the  innermost  or  nervous  tunic  of  the  eye, — 
a  delicate,  grayish,  transparent  membrane,  about  i^-^  of  an  inch  thick  at  the 
fundus,  2^^  ii'^ch  at  the  anterior  margin.  It  is  formed  by  a  membranous  ex- 
pansion of  the  optic  nerve  elements,  and  extends  from  the  termination  of  that 
nerve  nearly  as  far  forwards  as  the  ciliary  processes,  terminating  in  a  jagged 
margin,  the  Ora  Serrata,  though  its  fibrous  stroma  is  continued  as  the  Pars 
Ciliaris  RetincB  over  the  ciliary  body.  The  Retina  presents  for  examination 
the  following  points,  viz.,  the — 

Macula  Lutea,or  Yellow  Spot, — situated  on  the  retina,  exactly  in  the  visuai 
axis ;  is  an  elevated  oval  spot  where  vision  i«  very  acute,  the  retina  being 
very  thin  and  full  of  nerve  elements  closely  packed  together  at  the  ex- 
pense of  its  connective  tissue.  No  rods,  no  nerve-fibre  layer  here,  but 
me  cones  and  ganglion-cells  are  very  numerous. 
Fovea  Centralis, — a  depression  at  the  centre  of  the  macula  lutea,  ji^  to  -^^ 
inch  in  diameter,  in  which  the  sense  of  vision  is  most  acute. 


THE  RETINA. 


203 


Fig. loo. 


optic  Disc  or  Papilla, — the  point  where  the  optic  nerve  enters,  the  central 
artery  of  the  retina  piercing  its  centre.  It  lies  about  -^-^  inch  internal  to 
and  -^^  inch  below  the  posterior  pole  of  the  eye,  and  is  often  called  the 
Blind  Spot,  being  the  only  part  of  the  fundus  oculi  from  which  the  power 
of  vision  is  absent. 

Pars  Ciliaris  RetincB, — the  part  of  the  retinal  stroma  which  is  prolonged 
over  the  ciliary  body.     It  is  destitute  of  nerve-elements. 

Arteries  of  the  Retina, — arise  from  the  Arteria  Centralis  Retinoe  (br.  of  the 
ophthalmic),  just  behind  the  optic  disc;  run  chiefly  upwards  and  down- 
wards, accompanied  by  veins,  to  terminate  in  capillary  network.  No 
vessels  exist  in  the  fovea  centralis,  and  only  the  finest  capillaries  in  the 
macula  lutea. 

Describe  the  Structure  of  the  Retina.  It 
is  composed  of  nervous  elements,  blood-vessels, 
and  modified  connective  tissue  resembling  the 
neuroglia  of  the  brain,  arranged  in  9  or  lO 
layers,  from  within  outwards,  as  follows,  viz. — 

Membrana  Limitans  Interna, — a  perfectly 
transparent  membrane,  made  up  of  the 
retinal  connective  tissue,  and  lining  the 
inner  surface  of  the  retina  (shown  in  the 
cut  by  the  lowest  line). 

Optic  Nerve  Fibres,'^ — composed  of  the  ter- 
minal fibres  of  the  optic  nerve  radiating 
from  the  papilla  in  all  directions.  They 
consist  of  the  axis-cylinder  only. 

Ganglionic  Layer,"^ — a  very  thin  layer  of 
large  ganglion  cells,  having  large  nuclei 
and  nucleoli,  with  branching  processes  to 
the  optic  nerve  fibres  of  next  layer. 

Internal  Molecular  Layer,^ — fine  granules 
intersected  by  finest  nerve  fibres  and  con- 
nective tissue  elements. 

Internal  Granular  Layer,^ — small,  round 
cells  with  large  nuclei,  their  processes 
uniting  with  the  ganglion  cells. 

External  Molecular  Layer,^ — a  very  thin 
layer  of  fine  granules  and  nerve-fibrillae. 

External  Granular  Layer,^ — consists  of 
ellipsoid  cells,  forming  a  nucleated  en- 
largement of  Jacob's  membrane. 


204  VISCERAL  ANATOMY. 

External  Limiting  Membrane, — a  membranous  expansion  of  radial  con. 

nective  tissue,  perforated  by  foramina  (shown  in  the  cut  by  a  line  between 

6  and  "'). 
Rods  and  Cones,  or  Jacob's  Membrane,*^ — the  perceptive  layer  of  the  retina, 

composed  of  rods  and  cones  closely  packed  together,  like  palisades,  the 

termini,  probably,  of  the  optic  nerve  fibres. 
[A  tenth  layer  is  described  by  some  anatomists,  the  pigmentary  layer  of  the 

choroid.  8     See  a'«/<»,  p.  200.] 

Name  the  Essential  Elements  of  the  Retinal  Structure. 

Principal  Elements,  are  three,  as  follows,  viz. — 

Nerve  fibres, — which  in  the  molecular  layers  break  up  into  very  delicate 

plexuses.     In  their  course  are  found — 
Nerve-cells, — ordinary  bipolar  or  multipolar,  and  modified  ones,  the  so-called 

granular  layers  of  the  retina. 
Terminal  Organs, — the  rods  and  cones  of  Jacob. 
Subordinate  Elements,  are  two,  the — 

Modified  Connective  Tissue,— oi  spongy  nature. 
Vessels, — blood-vessels  and  lymphatics. 

The  Humors. 

What  is  the  Aqueous  Humor  ?  It  is  a  clear,  alkaline,  serous  fluid,  com- 
posed of  water  96.7,  albumen  o.i,  chloride  of.  sodium  and  extractive  matters 
3.2,  weighing  4  to  5  grains,  and  filling  the  anterior  and  posterior  aqueous 
chambers,  which  communicate  with  each  other  when  the  pupil  is  dilated 
sufficiently  to  remove  the  pupillary  margin  of  the  iris  from  the  surface  of  the 
lens.     The— 

Anterior  Chamber  of  the  Aqueous  Humor, — has  the  cornea  in  front  and  the 

iris  behind. 
Posterior  Chamber  of  the  Aqueous  Humor, — has  the  iris  in  front,  the  lens, 
zonula  and  ciliary  body  behind.     [The  existence  of  any  such  space  is 
denied  by  many  authorities.] 

Describe  the  Crystalline  Lens.  It  is  a  biconvex,  elastic,  transparent 
body,  enclosed  in  a  capsule,  held  in  place  by  a  suspensory  ligament,  and  situ 
ated  between  the  posterior  aqueous  chamber  and  the  chamber  of  the  vitreous 
humor,  immediately  behind  the  pupil.  Its  posterior  surface  is  the  most  convex, 
ftnd  rests  in  the  Hyaloid  Fossa  of  the  vitreous.     Its  — 

Dimensions  and  Weight, — diameter,  about  ^  inch, — axis  about  ^  inch, — 

weight,  4  to  4^  grains, — index  of  refraction,  1.44. 
Composition, — water  60,  soluble  albuminous  matter  35,  insoluble  albuminous 
matter  2.5,  fat  and  cholesterine  2  per  cent. 


THE  HUMORS   OF  THE  EYE.  205 

Capsule, — is  transparent,  elastic,  ^^^^  ^^^^^  thick  anteriorly,  -^-^^-^  inch  pos- 
teriorly ;  has  a  layer  of  flat  cells  between  its  anterior  portion  and  the  lens, 
which,  after  death,  break  down  into  a  fluid,  the  Liquor  Morgagni. 
Zonula  of  Zinn,  or  Suspensory  Ligament, — connects  the  capsule  with  the 
ciliary  body.     It  is  formed  by  a  splitting  of  the, 
hyaloid  membrane  into  two  layers,  one  going 
in  front  of  the  lens,  the  other  behind.     It  is 
shown  exaggerated  in  the  cut. 
Canal  of  Petit, — is  a  triangular  space  around  the 
circumference  of  the  lens,  formed  by  the  sepa- 
ration of   the  two  portions  of  the  suspensory 
ligament  (shown  inflated  in  the  cut). 
Processus  Zonules, — are  small  radiating  folds  on 

the  anterior  surface  of  the  suspensory  ligament,  which  are  received  be- 
tween the  ciliary  processes. 
Describe  the  Structure  of  the  Crystalline  Lens.  It  consists  of  flattened 
hexagonal  fibres,  united  laterally  into  lamellse,  by  serrated  edges,  and  curving 
around  the  borders  of  the  organ.  Its  centre  or  Nucleus  is  unstratified,  and 
denser  than  the  surrounding  portion  or  Cortex.  It  is  unorganized,  having  no 
vessels  or  nerves,  but  receives  its  nutriment  by  imbibition  from  the  uveal  tract, 
and  possibly  from  the  other  humors  of  the  eye. 

What  is  the  Vitreous  Humor  ?  The  Vitreous  Humor  or  Hyaloid  Body 
is  an  apparently  structureless  substance,  of  gelatinous  consistence,  consisting 
of  water  with  a  little  albumen  and  salts,  and  containing  cells,  nuclei,  and  con- 
nective-tissue filaments.  It  has  no  vessels  or  nerves,  and  is  situated  in  the 
posterior  chamber  of  the  eye,  behind  the  lens,  which  it  supports,  as  also  the 
retina.     The — 

Canal  of  Stilling,  Canal  of  Cloquet,  or  Hyaloid  Canal, — traverses  the  vit- 
reous humor  antero-posteriorly,  being  the  channel  for  the  transmission  in 
the  foetus  of  the  Hyaloid  A7'tery  to  the  membrana  pupillaris.  [See  ante^ 
p.  202,] 
Hyaloid  Fossa, — a  depression  on  the  anterior  surface  of  the  vitreous,  receiv- 
ing the  posterior  convexity  of  the  lens. 

What  is  the  Hyaloid  Membrane  ?     It  is  a  delicate  capsule  investing  the 

vitreous,  and  supposed  to  send  delicate  septa  into  the  substance  of  that  humor.  It 

divides  anteriorly  into  two  layers,  which  enclose  the  Canal  of  Petit  and  the  Lens, 

forming  the  suspensory  ligament  of  the  latter,  or  Zonula  of  Zinn.     [See  above.] 

The  foregoing  is  the  view  of  most  anatomists,  but  some  assert  that  this 

membrane  is  identical  with  the  internal  limiting  membrane  of  the  retina, 

extending  only  to  the  ora  serrata.     [Henle,  IwanofF,  etc.] 


??0(5  VISCERAL  ANATOMY. 

Others  admit  a  hyaloid  membrane  surrounding  the  vitreous,  but  deny  that 
it  sphts  to  enclose  the  lens,  and  assign  but  one  layer  to  the  suspensory 
ligament,  namely,  that  in  front  of  the  Canal  of  Petit.     [Gray,  etc.] 

Describe  the  Muscles  of  the  Eyeball.     They  number  6,  of  which  4  are 
Recti  and  2  Oblique,  as  follows : — 

Rectus  Superior,'^ — from  the  upper  margin  of  the  optic  foramen  and  the 

sheath  of  the  optic  nerve, — into  the  sclerotic  coat.     Action,  to  rotate  the 

eyeball  upwards.     Nerve,  3d  cranial. 
Rectus  Inferior,^ — from  the   ligament  of   Zinn, — into   the  sclerotic  coat. 

Action,  rotates  the  eyeball  downwards.     Nerve,  3d  cranial. 
Rectus  Internus,^ — from  the  ligament  of  Zinn, — into  the   sclerotic   coat. 

Action,  rotates  the  eyeball  inwards.     Nerve,  3d  cranial. 
Rectus  Externus,"^ — by  two  heads,  the  upper  from  the  outer  margin  of  the 

optic  foramen,  the  lower  from  the  ligament  of  Zinn  and  a  bony  process 

Fig. 102. 


at  lower  margin  of  the  sphenoidal  fissure, — into  the  sclerotic  coat.^o 
Action,  to  rotate  the  eyeball  outwards.  Nerve,  6th  cranial,  or  abducens. 
Between  the  two  heads  of  the  external  rectus  pass  the  3d,  nasal  branch 
of  the  5th,  and  the  6th  cranial  nerves,  and  the  ophthalmic  vein. 

Obliquus  Superior,'^ — from  about  a  line  above  the  inner  margin  of  the  optic 
foramen,  its  tendon  passing  through  a  "  pulley  "  ^  2  near  the  internal  an- 
gular process  of  the  frontal  bone  and  thence  beneath  the  rectus  superior, 
— into  the  sclerotic  coat,  at  right  angles  ^  to  the  insertion  of  the  rectus 
superior.  Action,  to  rotate  the  eyeball  on  its  antero-posterior  axis. 
Nerve,  4th  cranial,  or  patheticus. 

Obliquus  Inferior,^ — from  the  orbital  plate  of  the  superior  maxillary, — 
into  the  sclerotic  coat  below  the  insertion  of  the  external  rectus  and  at 
right  angles  thereto.  Action,io  rotate  the  eye  on  its  antero-posterior.axis. 
Nerve,  3d  cranial. 


^  THE  EYE.  207 

Vessels  and  Nerves  of  the  Eye. 
What  Nerves  supply  the  Muscles  of  the  Eye  ?     The — 

3d  Cranial,  or  Motor  t9(r«//,— supplies  the  superior,  inferior  and  internal  recti, 

and  the  inferior  oblique  muscles. 
4th  Cranial,  or  Trochlear, — supplies  the  superior  oblique  muscle. 
6th  Cranial,  or  Abducens, — supplies  the  external  rectus. 

Describe  the  Arteries  of  the  Eye.  The  Eye  is  supplied  by  the  Oph- 
thalmic and  Anterior  Cerebral  branches  of  the  internal  carotid  artery,  and 
the  Infra- orbit alhxdMch  of  the  internal  maxillary  (from  the  external  carotid). 
The— 

Ophthalmic, — arises  from  the  cavernous  portion  of  the  Internal  Carotid,  and 
enters  the  optic  foramen,  giving  off  the  follovi^ing-named  branches : — 

Lachrymal,— to  the  lachrymal  gland,  the  upper  eyelid,  and  the  conjunctiva, 
anastomosing  v^'ith  the  palpebral  arteries. 

5'«/ra;^r3//<z/,— supplies  the  superior  rectus  and  levator  palpebrse  muscles, 
the  forehead  and  pericranial  tissues. 

Anterior  and  Posterior  Ethmoidal, — to  the  dura  mater,  the  nose,  the  ante- 
rior ethmoidal  cells,  and  the  frontal  sinus. 

Palpebral, — superior  and  inferior, — to  the  eyelids. 

Frontal, — to  the  tissues  of  the  forehead. 

Nasal, — to  the  lachrymal  sac,  and  the  nose. 

Short  Ciliary,  12  or  /j, — pierce  the  sclerotic  at  the  lamina  cribosa,  supply- 
ing the  choroid  and  the  ciliary  processes. 

Long  Ciliary,  2, — pierce  the  sclerotic,  and  pass  forwards  between  it  and  the 
choroid,  to  supply  the  iris,  forming  two  arterial  circles  thereon,  the  Cir- 
culus  Major  Iridis  at  the  ciliary  border,  and  the  Circulus  Arteriosus  Iridis 
Minor  near  the  pupillary  margin. 

Anterior  Ciliary, — arise  from  the  muscular  branches,  pierce  the  sclerotic, 
and  join  the  great  arterial  circle  of  the  iris. 

Arteria  Centralis  Petince, — pierces  the  optic  nerve  obliquely,  and  is  dis- 
tributed to  the  retina. 

Muscular  Branches,  ^,— superior  and  inferior,  supply  the  muscles  of  the 
eyeball. 
Anterior  Cerebral,  branch  of  the  Internal  Carotid, — sends  nutrient  capil- 
laries to  the  optic  nerve. 
Infra-orbital,  branch  of  the  Internal  Maxillary  artery, — sends  branches  to  the 
inferior  rectus  and  inferior  oblique  muscles,  and  to  the  lachrymal  gland. 

Name  the  Principal  Lymph-spaces  of  the  Eyeball.     The — 

Canal  of  Schlemm, — around  the  circumference  of  the  iris. 
Peri- choroidal  Space, — between  the  choroid  and  the  sclerotic. 


208 


VISCERAL  ANATOMY. 


Space  of  Tenon, — ^between  the  globe  and  its  capsule. 
Vaginal  Spaces, — between  the  sheaths  of  the  optic  nerve. 

What  Veins  has  the  Eye  ?  It  has  two  main  trunks,  the  Superior  and 
Inferior  Ophthalmic  Veins,  which  empty  into  the  cavernous  sinus,  after  col- 
lecting the  blood  from  the  smaller  venous  channels  through  the  Vena:  Vorti- 
coste  of  the  choroid.  The  veins  of  the  eye  anastomose  freely  with  the  facial 
veins,  thus  permitting  the  escape  of  venous  blood  in  either  direction. 

Describe  the  Nerves  of  the  Eye.  They  are  the — 
Nerve  of  Special  Sense, — the  Optic,  or  2d  cranial  nerve. 
Motor  Nerves, — the  3d,  4th,  6th,  filaments  of  the  5th,  and  some  fibres  from 

the  sympathetic. 
Sensory  Nerve, — the  Ophthalmic  Division  of  the  5th,  giving  off  the — 

Lachrymal, — to  the  lachrymal  gland,  the  conjunctiva,  and  the  integument 
of  the  upper  eyelid. 

(Ganglionic. 
Long  Ciliary. 
Infra-trochlear. 


Fig.  103. 


INT.  TROCHLEAR 
NASAL 

CILIARY    BR 


Sympathetic  Branches, — arise  from  the  medulla,  cilio-spinal  region,  cavernous 
and  carotid  plexuses,  and  join  the  3d,  4th,  5th,  and  6th  nerves,  sending 
filaments  to  the  dilator  fibres  of  the  iris,  to  the  muscles  of  the  orbit  and  lids, 
to  the  ciliary  ganglion,  and  to  the  walls  of  the  arteries. 


APPENDAGES   OF  THE  EYE.  209 

Short  Ciliary, —  some  20  in  number,  arise  from  the  Ciliary  Ganglion  [See  ante, 

page  137],  pierce  the  sclerotic  and  go  to  the  ciliary  muscle,  choroid,  iris, 

cornea,  and  to  the  sheath  of  the  optic  nerve. 
Ascending, — from  Meckel's  ganglion  [See  ante,  page  137],  enter  the  orbit  by 

the  spheno- maxillary  fissure,  going  to  the  optic  nerve,  the  6th  nerve,  and  the 

ciliary  ganglion. 

Describe  the  formation  and  course  of  the  Optic  Tract.  The  fibres 
which  form  the  optic  tract  have  their  deep  origin  in  the  optic  thalamus,  corpora 
geniculata,  and  the  anterior  corpora  quadrigemina.  The  tract  winds  around  ihe 
crus  cerebri  as  a  flattened  band,  receiving  from  the  crus  a  few  fibres  of  attach- 
ment, and  also  fibres  from  the  lamina  cinerea  and  the  tuber  cinereum.  In 
front  of  the  latter  body  the  two  tracts  join  to  form  the  Optic  Commissure  or 
Chiasm.     [See  2  on  Fig.  61,  page  130.] 

What  is  the  arrangement  of  the  Fibres  in  the  Optic  Commissure .' 
As  generally  described,  the  fibres  undergo  a  partial  decussation,  as  follows, 
viz.,  the — 

Decussating  Fibres, — are  the  most  numerous.  They  lie  in  the  centre  of  the 
commissure,  and  pass  across  to  the  opposite  side,  connecting  the  retina  of 
each  eye  with  the  opposite  cerebral  hemisphere. 

Longitudinal  Fibres, — are  the  external  fibres  in  the  optic  tracts,  passing 
into  the  optic  nerve  of  the  same  side,  connecting  each  retina  with  the 
cerebral  hemisphere  of  its  own  side. 

Inter- cerebral  Fibres, — situated  posteriorly  in  the  commissure,  passing  from 
one  optic  tract  to  the  other. 

Inter-retinal  Fibres, — lie  anteriorly  in  the  commissure,  passing  from  one 
optic  nerve  to  the  other,  and  connecting  the  retina  of  one  eye  with  that 
of  the  other. 

Describe  the  Optic  Nerve.  The  Optic  Nerve  proper  is  the  2d  cranial 
nerve,  arises  from  the  optic  commissure,  passes  into  the  orbit  by  the  optic  fora- 
men in  company  with  the  ophthalmic  artery,  is  pierced  by  the  central  artery 
of  the  retina,  and  enters  the  eyeball  posteriorly  -^^  inch  inwardly  from  its  axis, 
piercing  the  sclerotic  and  choroid  coats,  and  finally  expanding  in  the  retina. 
It  is  surrounded  by  a  tubular  process  of  dura  mater,  which  as  the  nerve  enters 
the  orbit,  subdivides  to  form  both  the  sheath  of  the  nerve  and  the  periosteum 
of  the  orbit. 

Appendages  of  The  Eye. 

What  are  the  Tutamina  Oculi  ?  They  are  the  appendages  of  the  eye, 
including  the — 

Eyebrows,  or  Supercilia.  Lachrymal  Gland,  and  Duds. 

Eyelids,  or  Palpebrse.  Lachrymal  Sac. 

Conjunctiva,  or  lining  membrane.  Nasal  Duct. 


210  VISCERAL  ANATOMY. 

What  are  the  Eyebrows  ?  They  are  arched  elevations  of  the  integu- 
ment over  the  supra-orbital  arches,  are  covered  with  a  row  of  short  hairs, 
and  are  drawn  downwards  and  inwards  by  the  Corrugator  Supercilii  muscle. 
\^See  page  68.] 

Describe  the  Eyelids.  The  Palpebrse,  or  Eyelids,  are  two  thin,  movable 
folds,  placed  in  front  of  the  eye,  for  its  protection.  The  upper  lid  is  the  most 
movable  one,  having  its  own  levator  muscle,  the  Levator  palpebrae  superioris. 
\_See  page  68.]     The  — 

Palpebral  Fissure^ — is  the  space  between  their  free  margins,  its  outer  and 
inner  angles  being  termed  respectively  the  External  Canthns  and  Inter, 
nal  Canthus. 
Lacus  Lackrymalis, — is  a  small  triangular  space  at  the  internal  canthus, 

between  the  lids  and  the  globe. 
Lachrymal  Papilla, — on  the  edge  of  each  lid,  about   ^   inch  from   the 

internal  canthus. 
Ptmctum  Lachrymale, — a  minute  orifice  on  each  papilla,  and  the  beginning 
of  the  lachrymal  canal. 

Describe  the  Structure  of  the  Eyelids.  They  are  composed  externally 
of  skin,  internally  of  mucous  membrane  (the  palpebral  conjunctiva),  and  be- 
tween these  lie  areolar  tissue,  the  orbicularis  muscle,  tarsal  cartilage,  fibrous 
membrane,  Meibomian  glands,  vessels  and  nerves.     The — 

Orbicularis  Palpeorarum  Muscle, — is  very  thin  and  pale.      \^See  p.  68.] 
Tensor  Tarsi,  or  Horner's  Muscle,  [See  p.  68] — is  a  portion  of  the  orbicu- 
laris, compressing  the  punctum  and  the  sac. 
Tarsal  Cartilages, — are  plates  of  fibro- cartilage,  forming  the  framework  of 
the  lids.     The  upper  one  is  crescentic  in  shape,  the  lower  one  elliptical 
and  smaller. 
Tarsal  Ligaments, — are  fasciae  connecting  the  tarsal  cartilages  to  the  cir- 
cumference of  the  orbit.     Externally  they  connect  with  the  malar  bone, 
and  are  there  called  the  External  Canthal  Ligaments. 

^  Tendo   Oculi, — connects   the   inner   end  of 

r iG.  104. 

each  tarsal  cartilage  to  the  nasal  process 
of  the  superior  maxillary  bone. 
Meibomian  Glands,^ — are  sebaceous  glands 
imbedded  in  the  tarsal  cartilages,  30  to  40 
in  the  upper  lid,  20  to  ^o  in  the  lower  one. 
They  open  along  the  inner  edge  of  the  free 
border  of  each  lid,  and  furnish  a  sebaceous 
secretion,  to  prevent  adhesion  of  the  lids 
to  each  other. 


THE   LACHRYMAL   APPARATUS.  211 

Eyelashesy  or  Cilia, — are  a  double  or  triple  row  of  short  hairs,  situated  on 
the  free  margins  of  the  lids;  their  follicles  lying  in  the  connective  tissue 
beneath  the  tarsal  cartilages. 

Arteries, — are  the  Palpebral  branches  of  the  ophthalmic  artery,  forming 
the  Superior  and  Inferior  Tarsal  Arches,  and  anastomosing  with  the 
angular,  anterior  temporal,  lachrymal  and  transverse  facial. 

Nerves, — the  3d,  facial  and  sympathetic  to  the  muscles;  the  5th  to  the  skin 
and  conjunctiva. 

What  is  the  Conjunctiva  ?  It  is  the  mucous  membrane  which  lines  the 
eyelids,  and  is  reflected  over  the  front  of  the  sclerotic  and  cornea.  It  is  con- 
tinuous with  the  mucous  lining  of  the  Meibomian  glands,  canaliculi,  lachry- 
mal sac,  nasal  duct,  lachrymal  duct  and  gland.     The — 

Palpebral  Conjunctiva, — consists  of  connective  tissue  covered  by  epithe- 
lium, is  traversed  by  furrows,  and  has  papillae  and  follicular  glands. 

Ocular  Conjunctiva, — is  very  thin  and  transparent,  loosely  attached  on  the 
sclerotic,  firmly  adherent  over  the  cornea,  where  it  has  no  vessels  in  its 
structure.     It  has  very  few  papillae,  and  no  glands. 

Retro-tarsal  or  Palpebral  Folds,  —superior  and  inferior, — are  where  the  con- 
junctiva is  reflected  over  the  globe.  They  contain  prominent  papillae,  and 
conglomerate  glands,  called  the  accessory  lachrymal  glan<ls. 

Plica  Semilunaris,  or  Semi-lunar  Folds, — a  crescentic  fold  of  conjunctiva 
at  the  inner  canthus,  considered  to  be  the  rudiment  of  the  Membrana 
Nictitans  or  3d  eyelid  (of  birds). 

What  is  the  Caruncula  Lachrymalis  ?  It  is  a  small,  red,  conical  body, 
situated  in  the  lacus  lachrymalis,  at  the  inner  canthus  of  the  eye ;  consisting 
of  hair  follicles  and  sebaceous  glands,  and  covered  by  conjunctiva.  It  is  con- 
nected by  tendinous  fibres  to  the  capsule  of  Tenon  and  to  the  rectus  internus 
muscle. 

Name  the  parts  constituting  the  Lachrymal  Apparatus.  They  are 
the  lachrymal  gland  and  its  ducts,  the  accessory  conjunctival  glands,  the 
canaliculi,  lachrymal  sac,  and  nasal  duct. 

Describe  the  Lachrymal  Gland.  It  is  an  oval  gland  situated  in  a  fossa 
of  the  orbital  portion  of  the  frontal  bone,  at  the  outer  angle  of  the  orbit,  its 
inferior  surface  reeling  on  the  eyeball,  its  lower  margin  or  lobe  being  covered 
by  conjunctiva.     The — 

Tarso-orbital  Fascia, — connects  the  lachrymal  gland  to  the  bony  roof  of 

the  orbit. 
Ducts, — 6  to  12  in  number;   open  on  the  upper  and  outer  portion  of  the 

palpebral  conjunctiva. 
Secretion — (tears), — lubricates  the  anterior  surface  of  the  eyeball.     Excess 


212 


VISCERAL  ANATOMY. 


F"^  ^°5-  evaporates,  or  collects  in  lacus  and 

passes  through  puncta  into  canaliculi, 
and  so  to  lachrymal  sac,  and  thence, 
by  the  nasal  duct,  into  the  inferior 
meatus  of  the  nose. 

What  are  the  Canaliculi  ?  They  are 
two  minute  canals,  ^-^  inch  in  diameter 
and  ^  inch  long,  which  extend  from  the 
punctum  in  each  lid  to  the  lachrymal  sac. 
They  are  lined  with  mucous  membrane,  and 
enveloped  by  fibres  of  the  tensor  tarsi  muscle. 

Describe  the  Lachrymal  Sac.     It  is 

the  superior  dilated  extremity  of  the  nasal 
duct,  and  is  situated  in  the  groove  formed  by  the  lachrymal  bone  and  the 
nasal  process  of  the  superior  maxillary.  Its  form  is  oval,  flattened  antero- 
posteriorly ;  its  dimensions  about  |  inch  long  and  \  inch  wide.  Its  fundus  is 
crossed  by  the  tarsal  ligament,  and  by  the  tensor  tarsi  muscle.  Its  junction 
with  the  nasal  duct  may  be  interrupted  by  folds  of  the  lining  mucous  mem- 
brane. 

What  is  the  Nasal  Duct  ?  A  membranous  canal  extending  from  the 
lachrymal  sac  to  the  inferior  meatus  of  the  nose.  It  is  about  ^  inch  long,  ^ 
inch  in  diameter,  is  contained  in  the  osseous  lachrymal  canal,  curving  down- 
wards, backwards  and  outwards,  and  its  calibre  is  narrowest  about  its  middle. 
Its  mucous  lining  is  thick,  and  continuous  with  the  Sclineiderian  membrane  of 
the  nasal  cavity.  Surrounding  it  is  a  vascular  network  of  connective  tissue, 
and  outside  this,  a  tendinous  sheath.  At  its  lower  end  a  fold  of  mucous  mem- 
brane forms  an  imperfect  valv2. 


THE  EAR. 

What  Bone  contains  the  Auditory  Apparatus  ?  The  petrous  and  mas- 
toid portions  of  the  Temporal  b©ne.     [Described  on  page  i6.] 

Name  the  Divisions  of  the  Auditory  Apparatus.  The  organ  of  hear- 
ing consists  of  the  following  parts,  viz. — 

I.  External  Ear. 


Auricle,  or  Pinna. 


2.  Middle  Ear ^  ox  Tympanum. 


\  External  Auditory  Canal. 

Membrana  Tympani. 
Cavity  of  the  Tympanum. 


Mastoid  Cells. 
Eustachian  Tube. 


3.  Internal  Ear,  or  Labyrinth . 


THE  EAR.  213 


Vestibule. 

Semicircular  Canals. 
Cochlea. 
Auditory  Nerve. 


The  External  Ear. 

Describe  the  Auricle.  The  Auricle  or  Pinna  is  the  external  iiTegularly 
shaped  appendage,  fastened  to  the  malar  and  temporal  bones  by  elastic  fibres. 
It  consists  of  a  broad  plate  of  yellow  cartilage,  deficient  in  places  where  its 
parts  are  joined  together  by  ligame  itous  tissue,  and  is  covered  by  perichon- 
drium and  integument,  the  latter  containing  sebaceous  and  sweat  glands,  and 
provided  with  short,  downy  hairs.  The  Auricle  presents  several  elevations 
and  depressions,  named  as  follows:  — 

Concha, — the  central  cavity  leading  into  the  canal. 

Tragus, — a  conical  eminence  in  front  of  the  concha,  usually  covered  with 

hairs  along  its  inferior  border. 
Anti-tragus, — a  similar  projection  facing  the  tragus,  from  which  it  is  sepa- 
rated by  a  deep  fissure,  the  Incisura  Intertragica. 
Helix, — the  outer  curved  edge  of  the  pinna,  beneath  which  is  a  deep  groove, 

the  Fossa  Navicularis. 
Anti-helix, — a  curved  ridge  along  the  posterior  boundary  of  the  concha, 
bifurcating  above  to  enclose  a  triangular  depression,  nam-^d  the  Fossa 
Triangula  ris. 
Lobe  or  Lobule, — ^the  soft,  pendulous  portion,  composed  of  integumentary, 
adipose  and  connective  tissues. 

Name  the  Muscles  of  the  Auricle.    The — 

Extrinsic  Muscles  are  the— 
Attolens  Au7'em,  Attrahens  Aurem,  Retrahens  Aurem. 
[These  muscles  are  described  on  page  68.] 
Intrinsic  Muscles  are  but  slightly  developed.     They  are  the — 
Tragicus,  —  \\^%  vertically  on  the  outer  surface  of  the  tragus. 
Anti  tragicus,—oxi.  the  posterior  wall  of  the  auditory  canal. 
Helicis  Major, — vertically  on  the  anterior  border  of  the  helix. 
Helicis  Minor^ — on  lateral  surface  of  the  root  of  the  helix. 
Transversus  Auriculce, — on  the  posterior  surface  of  the   auricle,  radiating 

outwards  from  the  convexity  of  the  concha. 
Obliquus  Auriculce, — -also  on  the  posterior  surface,  radiating  upwards  from 

the  convexity  of  the  concha. 
Dilator  of  Concha, — on  the  tragus. 


214  VISCERAL  ANATOMY. 

Name  the  Arteries  and  Nerves  of  the  Auricle.     The — 
Arteries, — are  derived  from  the  External  Carotid.     The — 

Posterior  Auricular, — a  main  branch  of  the  external  carotid. 

Anterior  Auricular,  branch  of  the  Temporal  br.  of  the  ext.  carotid. 

Auricular, — ^branch  of  the  Occipital  branch  of  the  ext.  carotid. 
Nerves, — are  the — 

Auriculus  Magnus, — from  the  cervical  plexus.     [See  p.  133.] 

Posterior  Auricular, — from  the  facial  nerve. 

Auricular, — ^branch  of  the  pneumogastric  (also  called  Arnold's  nerve). 

A uriculo- temporal, — branch  of  the  inferior  maxillary  div.  of  the  5th. 

Describe  the  External  Auditory  Canal.  It  is  an  osseo-cartilagino'" 
tube,  about  1%  inch  long,  extending  from  the  concha  to  the  membrana  tym- 
pani,  and  curved  irregularly  in  its  course.  The  cartilaginous,  or  external  por- 
tion, is  about  ]4  i"ch  long,  and  deficient  posteriorly  and  above,  where  it  is 
filled  by  strong  fibrous  tissue.  The  canal  is  lined  with  integument,  having 
numerous  hair  follicles,  sebaceous  and  ceruminous  glands. 

Sulcus  Tympanicus, — a  groove  at  the  bottom  of  the  canal  for  the  insertion 
of  the  membrana  tympani.     It  is  interrupted  above  by  the — 

Segment  of  Rivinus, — at  the  upper  part  of  the  sulcus  tympanicus,  each  end 
having  an  osseous  spine,  the  Spina  Tympanica  Major  and  Minor. 

What  are  the  Relations  of  the  External  Auditory  Canal  ?  In  front, 
the  articulation  of  the  lower  jaw;  below  and  in  front,  ik^  parotid  gland', 
behind,  the  mastoid  cells  and  the  transverse  sinus ;  above,  the  mastoid  cells 
and  the  dura  mater  of  the  brain. 

Name  its  Vessels  and  Nerves.     Its — 
Arteries, — are  branches  of  the  Posterior  and  Deep  Auricular. 
Nerves, — are  chiefly  derived  from  the  Temporo-auricular  Branch  of  the  inferioi 

maxillary  division  of  the  5th  nerve. 

The  Membrana  Tympani. 
What  is  the  Membrana  Tympani?  The  Membrana  Tympani,  01 
Drumhead,  is  an  oval,  inelastic,  semi-transparent  membrane,  about  -^\-^  inch 
in  thickness,  situated  obliquely  at  the  bottom  of  the  external  auditory  canal, 
which  it  separates  from  the  cavity  of  the  tympanum.  Seen  through  the  canal, 
it  is  of  a  delicate  blue-gray  color,  arched  inwards,  and  presenting  for  consid- 
eration the  following  points,  viz.  : — A 

Tubercle, — white  in  color  at  the  upper  border,  made  by  the  short  process 

of  the  malleus. 
Stripe, — also  white,  running  downwards  from  the  tubercle,  and  formed  by 
the  handle  of  the  malleus. 


THE  MEMBRANA   TYMPANI.  216 

Light-spot, — a  triangular  reflection,  its  apex  at  the  tip  of 

the  malleus-handle,  its  base  extending  to  the  periphery 

of  the  membrane.     It  is  due  to  the  concavity  of  the  V , 

drumhead. 
Umbo, — or  shadow,  is  the  darker  central  portion. 
ShrapnelFs  Membrane, — is  the  upper  posterior  part  of 

the  drumhead,  where  it  is  somewhat  flaccid. 
Rivinian  Foramen, — a  minute  opening  supposed  to  exist 

in  the  portion  called  Shrapnell's  membrane. 
In  what  direction  is  the  Membrana  Tympani  placed  ?     Obliquely 
inwards  and  forwards,  almost  forming  a  continuation  of  the  posterior  wall  of 
the  external  auditory  canal. 

Describe  the  Structure  of  the  Membrana  Tympani.     It  is  composed 
of  3  layers,  as  follows : — 

External,  or  Dermoid  Layer, — continuous  with  the  integument  lining  the 

external  auditory  canal. 
Middle  Layer,  or  Lamina  Propria, — formed  of  outer  radiating  fibres,  and 

inner  circular  ones.     Between  these  two  sets  of  fibres  are  situated  the 

short  process  and  handle  of  the  malleus. 
Internal  or  Mucous  Layer^ — is  continuous  with  the  mucous  lining  of  the 

tympanum. 
Tendinous  Ring  {Ai,  Fig.  lo6), — surrounds  the  margin  of  the  membrane, 

being  received  into  the  sulcus  tympanicus.     Its  anterior  and  posterior  ends 

are  shown  by  v  and  ^  in  Fig.  1 06. 
What  Structures  are  presented  by  its  Internal  Surface  ?     A  fibrous 
fold  descends  from  the  upper  portion  of  the  marginal  ring,  for  a  short  distance 
along  the  malleus-handle,  forming  the — 
Anterior  and  Posterior  Pouches, — one  on  each  side  of  the  malleus-handle, 

opening  downwards. 
Tendinous  Bands, — 4  or  5, — converge  from  the  posterior  margin  to  the 

middle  of  the  malleus-handle. 

What  Arteries  Supply  the  Membrana  Tympani  ?     The — • 
Deep  Auricular,hra.nch  of  the  internal  maxillary, — supplies  the  external  layer. 

and  forms  with  the  Tympanic  Branches  a  capillary  plexus  in  the  middle 

layer,     (von  Trolsch,  Roosa,  etc.) 
Tympanic,  branches  of  the  internal  maxillary  and  internal  carotid  arteries,— 

supply  the  internal  layer,  and  anastomose  on  the  membrana  tympani  with 

the— 
Vidian  and  Stylo- mastoid, — branches  respectively  of  the  internal  maxillairy 

and  posterior  auricular  branches  of  the  external  carotid. 


216  VISCERAL  ANATOMY. 

What  Nerves  supply  the  Membrana  Tympani  ?     The  external  layer 

contains  filaments  from  the  Superficial  Temporal  hxzx\c\\  of  the  5th;  the  inner 
layer  is  supplied  by  the  Tympanic  Plexus.     (See  Nerves  of  Tympanum.) 

The  Tympanum. 
Describe  the  Tympanum.  The  Tympanum,  Drum,  or  Middle  Ear,  is 
an  irregularly-shaped  cavity  lying  between  the  membrana  tympani  and  the 
internal  ear,  and  communicating  with  the  pharyngeal  cavity  by  the  Eustachian 
tube.  It  contains  the  ossicles  of  the  tympanum,  part  of  the  chorda  tympani 
nerve,  and  air.  Its  average  diameters  are  about  \  inch  anteroposteriorlyp 
^  to  I  inch  vertically,  and  -^^  to  \  inch  transversely. 

Name  the  Points  on  each  wall  of  the  Tympanum.     Its — 
Roof, — is  very  thin,  and  corresponds  to  a  depression  on  the  anterior  surface 

of  the  petrous  portion  of  the  temporal  bone. 
Floor, — is  a  thin  plate,  separating  it  from  the  jugular  fossa  and  vein.     Has — 

Opening  for  Jacob  son' s  Nerve, — in  the  floor. 
Outer  Wall, — is  formed  by  the  membrana  tympani  and  presents  the — 
Iter  Chordcs  Posterius, — opens  close  to  posterior  edge  of  drumhead,  for  the 

entrance  of  the  chorda  tympani  nerve. 
Iter  Chordce  Anterius,  or  Canal  of  Hugier, — opening  just  in  front  of  the 

drumhead,  for  the  exit  of  the  chorda  tympani  nerve.     (See  p.  16.) 
Glaserian  Fissure, — opens  above  and  in  front  of  the  drumhead,  receiving 
the  long  process  of  the  malleus,  the  anterior  ligament  of  the  malleus,  and 
the  tympanic  artery.     (See  ante,  p.  15.) 
Inner  Wall, — is  the  outer  wall  of  the  labyrinth; — presents  the — 

Fenestra  Ovalis, — an  oval  opening,  leading  into  the  vestibule,  and  closed 

by  a  membrane,  to  which  is  attached  the  base  of  the  stapes. 
Fenestra  Rotunda, — a  smaller  opening,  below  the  fenestra  ovalis,  leading 
into  the  scala  tympani  of  the  cochlea,  and  closed  by  the  Membrana  Tym- 
pani Secundaria. 
Promonotory, — an  elevation  corresponding  to  the  first  turn  of  the  cochlea, 

situated  between  the  fenestrse  and  in  front  of  them. 
Hidge  of  the  Aqueductus  Fallopii,—2ihov&  the  fenestra  ovalis, behind  which 

it  curves  downwards  along  the  posterior  wall. 
Pyramid, — a  conical  eminence  containing  a  canal  which  communicates  with 
the  aqueductus  Fallopii  and  encloses  the  stapedius  muscle. 
Anterior  Wall, — presents  the — 

Opening  of  Canal  for  the  Tensor  Tympani  Muscle, — above,  situated  on  a 

small  projection,  the  Anterior  Pyramid. 
Opening  of  the  Eustachian  Tube, — next  below.     These  two  canals  being 
Separated  by  a  bony  lamina,  the  Septum  Tuba. 


THE  TYMPANUM.  217 

Processus  Cochleariformis, — the  small  end  of  the  septum  tubae,  projecting 
into  the  tympanum.     (See  p.  17.) 
Posterior  Wall,  separates  it  from  the  mastoid  cells,  and  presents  the — 
Openings  of  the  Mastoid  CeMs.     Ridge  of  the  Aqueductus  Fallopii,  curving 
downwards  and  nearly  vertically.     (See  above.) 

Describe  the  Ossicles  of  the  Tympanum.  They  are  three  small  bones, 
which  form  a  chain  across  the  tympanic  cavity,  connecting  the  membrana 
fympani  with  the  fenestra  ovalis,  and  named  the — 

Malleus^  or  Hammer yA — consists  of  a  head,  neck,  short  process,  .ong  pro- 
cess, or  Processus  Gracilis^  and  handle,  or  Manubrium.  The  short  pro- 
cess and  handle  are  fastened  to  the  middle  layer  of  the  drumhead.  The 
long  process  is  received  into  the  Glaserian  fissure,  and  the  head  articulates 
with  the  head  of  the  Incus. 

Incus,  or  Anvil,B — has  a  head,  also  a  long  and  a  short  process.  The  head 
articulates  with  the  head  of  the  malleus,  the 
short  process  with  the  posterior  wall  of  the 
t3mipanum,  the  long  process  with  the  head  of 
the  stapes,  by  the  Os  Orbiculare,  its  convex  ex- 
tremity. 

Stapes,  or  Stirrup, C — presents  a  head,  neck,  base 
and  crura.  Its  head  articulates  with  the  incus, 
its  base  rests  on  the  membrane  closing  the 
fenestra  ovalis,  its  neck  receives  the  tendon  of 
the  stapedius  muscle. 

Name  the  Ligaments  of  the  Ossicles.     They  are  the — 
Ligamentum  Mallei  AnteriuSj — from  the  spina  tympanica  major  to  the  neck 

and  long  process  of  the  malleus. 
Lig.  Mallei  Externumy — from  the  border  of  the  Rivinian  segment  (p.  214), 

to  the  neck  of  the  malleus.     Its  posterior  fibres  are  the — 
Lig.  Mallei  Posticum, — (Laxator  tympani  minor  muscle  of  Sommering) — is 

simply  the  posterior  group  of  fibres  of  the  preceding  ligament. 
Lig.  Mallei  Sttperius ,—{S\xs'^Qnsovy  lig.  of  the  malleus)  from  the  roof  of  the 

tympanum  to  the  head  of  the  malleus. 
Lig.  Incudis   Super ius,—ixom  the  roof  of  the  tympanum  to  the  head  of  the 

incus  (Arnold). 
Lig.  Incudis  Posticum,— ^xom  the  posterior  wall  of  the  tympanum  to  the  short 

process  of  the  incus. 
Lig.  Obturatorium  Stapedium, — a  thin  membrane  which  closes  the  opening 

between  the  crura  of  the  stapes. 


218  VISCERAL  ANATOMY. 

Annular  Ligament^ — connecting  the  base  of  the  stapes  to  the  margin  of  the 
fenestra  ovalis. 

Capsular  Ligaments, — around  the  articulations  between  the  ossicles  them- 
selves, which  articulations  are  lined  by  synovial  membranes,  with  articular 
cartilages  between  the  contiguous  surfaces. 

Name  the  Muscles  of  the  Tympanum.  Three  are  usually  described, 
— the  Tensor  Tympanic  Laxator  Tympani,  and  the  Stapedius.  A  fourth,  the 
Laxator  Tympani  Minor^  is  now  generally  omitted,  being  considered  the 
posterior  ligament  of  the  malleus  by  most  writers.  Many  otologists  omit 
ihe  Laxator  Tympani  from  the  list  also.  [These  muscles  are  described  on 
page  71.] 

What  Arteries  supply  the  Tympanum  ?     The — 
Tympanic y — branch  of  the  internal  maxillary,  entering  the  Glaserian  fissure, 
anastomosing  on  the  membrana  tympani,  in  a  vascular  circle,  with  the  Stylo- 
mastoid and  Vidian  arteries,  and  the  Tympanic  br.  of  the  internal  carotid. 
Stylo  mastoid, — br.  of  the  posterior  auricular  br.  of  the  external  carotid,  en- 
tering at  the  stylo-mastoid  foramen. 
Petrosal, — br.  of  middle  meningeal  artery,  entering  by  the  hiatus  Fallopii. 
Tympanic, — br.  from  the  internal  carotid  artery.     (See  p.  105.) 
Vidian, — br.  of  the  internal  maxillary  br.  of  the  external  carotid. 
Branches, — from  the  ascending  pharyngeal  br.  of  the  external  carotid. 

Name  the  Nerves  of  the  Tympanum.     The — 

Tympanic  Br.  of  the  Glossopharyngeal  (Jacobson's  Nerve), — enters  the  tym- 
panum through  its  floor,  and  supplies  the  two  fenestrae  and  the  mucous  lin- 
ing of  the  cavity,  helping  to  form  the  Tympanic  Plexus  (see  below). 

Tympanic  Branch  of  the  Facial  Nerve, — to  the  stapedius  and  laxator  tympani 
muscles. 

Branch  from  the  Otic  Ganglion, — to  the  tensor  tympani  muscle.  [This 
ganglion  is  described  on  page  137.] 

Chorda  Tympani  Br.  of  the  Facial^ — enters  the  tympanum  by  the  iter  chordae 
posterius,  crosses  the  cavity  between  the  handle  of  the  malleus  and  the  long 
process  of  the  incus,  and  makes  its  exit  by  the  iter  chordce  anterius,  after 
passing  close  along  the  upper  part  of  the  membrana  tympani. 

How  is  the  Tympanic  Plexus  Formed  ?     By  the — 

Tympanic  Br.  of  the  Glosso- Pharyngeal, — or  Jacobson's  nerve. 

Branch  of  the  Superficial  Petrosal,  from  the  Facial, — entering  from  above. 

Branches  from  the  Carotid  Plexus  of  the  Sympathetic, — through  the  wall 
of  the  carotid  canal. 

The  plexus  lies  in  grooves  on  the  inner  wall  around  the  promontory,  and  sup- 
plies the  mucous  membrane  of  the  tympanum. 


the  internal  ear.  219 

The  Eustachian  Tube. 
What  is  the  Eustsichian  Tube  ?  It  is  an  osseo- cartilaginous  canal,  about 
lyi  inches  long,  ^^  inch  in  diameter  at  tympanic  end,  ]^  inch  at  pharyngeal, 
which  leads  downwards  and  forwards  from  the  tympanic  cavity  into  the 
pharynx.  Of  its  length  two- thirds  is  cartilaginous,  one-third  osseous.  Above 
its  bony  portion  is  the  canal  for  the  tensor  tympani  muscle,  from  which  it  is 
t^ivided  by  an  osseous  lamina,  the  Septum  Tubce.     Its — 

Cartilaginous  Fornon,— consists  of  two  plates  of  cartilage,  their  non-ap- 

proximated  edges  being  connected  by  a  membrane. 
Pharyngeal  Orifice^ — is  trumpet- shaped,  and  situated  in  the  posterior  nasal 

space,  just  above  the  nasal  floor. 
Mucous  Membrane^ — covered  with  the  ciliated  epithelium,  and  continuous 
with  that  of  the  pharynx  and  the  tympanum. 

Describe  the  Muscles  of  the  Eustachian  Tube.     They  are  the — 
Spheno- salpingo- staphylinusy — the  abductor  or  dilator  of  the  tube — is  described 

as  arising /re* A'z  the  sphenoid  bone  and  the  cartilage  of  the  tube,  and  being 

inserted  into  the  convex  border  of  the  outer  cartilage  for  its  whole  length. 

Nerve, — internal  pterygoid. 
Levator  Veli  Palaii, — exists  from  the  temporal  bone  and  the  cartilage  of  the 

tube, — into  the  osseous  tube,  the  cartilage,  and  the  mucous  membrane. 

Action,  to  enlarge  the  transverse  diameter  of  the  tube.     Nerve,  pneumo- 

gastric. 
Salpitigo-pkaryngeus, — a  thin  layer  disposed  along  the  median  cartilaginous 

plate   and   the   mucous   membrane.     Action,  to  fix  the  median  cartilage. 

Called  a  fascia  by  some  anatomists. 

What  Art.eries  supply  the  Eustachian  Tube  ?     The — 

Ascending  Pharyngeal, — branch  of  the  external  carotid. 

Middle  Meningeal, — branch  of  the  internal  maxillary  br.  of  the  ext.  carotid. 

Branch:, — from  the  internal  carotid  artery. 

Name  its  Nerves.     Besides  those  which  supply  the  muscles  of  the  tube 
(3fte  above),  it  h^'s  branches  from  the — 

Superior  Pharyngeal.  Glosso-pharyngeal. 

The  Internal  Ear. 
Name  the  Parts  comprised  in  the  Internal  Ear. 

{Vestibule. 
Semicircular  Canals, 
Cochlea. 


220 


VISCERAL  ANATOMY. 


Membranous  Labyrinth,  comprises  the 


Utricle, 

Membranous  Seminrcular  CanaU 

Saccule. 

Membranous  Cochlea. 

Auditory  Nerve, — the  8th  cranial  nerve,  or  the  Portio  Mollis  of  the  7th. 

Organ  of  Corti, — the  terminal  auditory  apparatus. 

Internal  Auditory  Canal, — by  which  the  auditory  nerve  enters. 

Describe  the  general  arrangement  of  the  Internal  Ear.     It  lies  in- 

ternal  to  the  tympanum,  within  the  petrous  portion  of  the  temporal  bone,  and 
consists  of  a  series  of  osseous  chambers,  the  Osseous  Labyrinth,  containing  a 
fluid,  the  Perilymph,  or  Liquor  Cotunnii,  in  which  lies  a  membranous  repro- 
duction of  the  chambers,  the  Membranous  Labyrinth,  which  also  contains  a 
fluid,  the  Endolymph,  or  Liquor  Scarpce.  Upon  the  membranous  labyrinth 
are  distributed  the  terminal  filaments  of  the  auditory  nerve,  which  being  sus- 
pended between  two  fluids,  are  not  only  protected  from  injury,  but  enabled  to 
perceive  the  most  delicate  vibrations  which  may  be  communicated  to  the  fluids 
surrounding  them. 

Describe  the  Vestibule.  It  is  the  common  cavity  of  communication 
between  the  osseous  parts  of  the  internal  ear,  and  measures  in  vertical  diameter 
about  \  inch,  laterally  about  -^^  inch.  It  communicates  in  front  with  the  scala 
vestibuli  of  the  cochlea;  and  behind  (by  five  openings)  with  the  semicircular 
canals.     It  presents  the  following  points,  viz. : — the — • 

pjfj  jq8.  Fenestra    Ovalis, — on    its    outer  wall, 

closed  by  the  base  of  the  stapes  and 
its  annular  ligament. 
Fovea  Hemispheric  a, b — a  small  circular 
depression  on  the  inner  wall,  for  the 
saccule. 
Macules  CricoscB, — are  groups  of  very 
minute  orifices  on  the  inner  wall,  ad- 
mitting the  nerve  filaments. 
Crista,   or    Pyramidal   Eminence,— z. 
vertical    ridge    on    the    inner    wall, 
bounding  the  fovea  posteriorly. 
Aqueductus  Vestibuli,d — opens  behind  the  crista,  ending  on  the  posterior 
surface  of  the  petrous  portion  of  the  temporal  bone.     It  contains  a  small 
bhnd  canal  opening  by  two  arms,  one  into  the  utricle,  the  other  into  the 
saccule ;  also  a  small  vein. 
Fwea  Semi-elliptica/* — a  small  oval  depression  on  the  roof,  above  and  be- 


THE   INTERNAL  EAR.  221 

hind  the  fovea  hemisph erica.    It  lodges  the  utricle,  and  presents  a  Macula 
Cribosa  for  the  entrance  of  branches  of  the  vestibular  nerve. 

What  are  the  Semicircular  Canals  ?  They  are  three  C-shaped  bony 
tubes,  each  aoout  -^^  inch  in  diameter,  situated  above  and  behind  the  vestibule, 
into  which  they  open  by  5  apertures.  Each  canal  lies  at  a  right  angle  with 
the  other  two.     The — 

Superior  and  Posterior/  Canals^ — are  each  nearly  an  inch  long,  vertically 
placed,  joined  together  posteriorly  where  they  open  into  the  vestibule  by 
a  common  orifice.^ 
External  Canal,  g — is  \  inch  long,  horizontally  placed,  and  directed  out- 
wards and  backwards. 
Ampulla, — is  a  flask-shaped  dilatation  of  each  canal  at  one  extremity, 
having  a  diameter  of  about  -^^  inch. 

Describe  the  Cochlea.     The  Cochlea  is  a  bony  tube,  about  i^  inch  long, 

tapering  from  ^-^  to  -^^  inch  in  diameter,  coiled  around  a  central  conical  axis 

for  2^  turns,  and  resembling  a  snail  shell  in  appearance.     It  measures  about 

^  inch  in  length  and  the  same  in  breadth  at  the  base.     It  is  situated  in  front 

of  the  vestibule,  its  apex  pointing  forwards  and  outwards,  and  is  separated 

from  the  carotid  canal  in  front  by  a  thin 

1.       -.-  Fig. 

wall.     Its— 

Modiolus y  a — is  the  central  axis,  conical 
in  shape,  channeled  by  small  canals 
for  the  passage  of  arteries  and  nerves, 
and  by  a  central  one,  the  Canalis 
Centralis  Modioli.  Its  apex  is  within 
the  last  coil  of  the  cochlea,  and  is  ex- 
panded into  a  funnel-shaped  lamella,  the  Infundibulum. 

Lamina  Spiralis,  ^ — is  a  thin,  osseous  plate,  projecting  from  the  modiolus 
half  way  across  the  spiral  canal,  and  winding  around  the  modiolus  ter- 
minates near  the  apex  in  a  hook-like  or  Hamular  Process.  Its  deficiency 
in  the  last  half  turn  of  the  cochlea  forms  the  Helicotrema,  a  space  in 
which  the  scalse  vestibuli  and  tympani  unite.  (See  below.)  It  consists 
of  two  laminae,  1,  2,  between  which  pass  the  filaments  of  the  cochlear 
nerve.  ^  ^  From  its  free  edge  the  structures  composing  the  membranous 
cochlea  pass  to  their  attachment  on  the  opposite  wall  of  the  cavity.  (See 
Fig.  III.) 

Spiral  Canal, — is  the  space  between  the  modiolus  and  the  outer  wall  of  the 
cochlea.  It  makes  2}^  turns, — from  left  to  right  in  the  right  ear,  from 
right  to  left  in  the  left  ear:  and  terminates  in  the  Cupola ,  a  cul-de-sac  at 
the  apex  of  the  cochlea.     It  is  divided,  by  the  osseous  lamina  spiralis  and 


222  VISCERAL  ANATOMY. 

the  membranous  cochlea,  into  2  Scalae, — the  Scala  Vestibuli^  and  the 
Scala  Tympani.'^     [Fig.  ill.] 
[A  third  scala  is  described  by  many  authorities, the  Scala  Media,^  including 
the  space  occupied  by  tHe  membranous  cochlea.     See  Fig.  1 11.] 

Describe  the  Scala  Vestibuli.  It  is  the  portion  of  the  spiral  canal  lying 
above  the  lamina  spiralis  and  the  membranous  cochlea ;  communicates  with 
the  vestibule  below,  and  with  the  scala  tympani  above  at  the  Helicotrema.  It 
is  filled  with  perilymph. 

What  is  the  Scala  Tympani  ?  It  is  the  portion  of  the  spiral  canal  lying 
below  the  lamina  spiralis  and  the  membranous  cochlea,  communicates  with 
the  aqueductus  cochlea  (see  below),  and  with  the  scala  vestibuli  at  the  Heli- 
cotrema. It  terminates  inferiorly  at  the  fenestra  rotunda,  and  is  filled  with 
perilymph. 

What  is  meant  by  the  Helicotrema  ?  It  is  a  space  at  the  apex  of  the 
cochlea,  formed  by  the  deficiency  of  the  lamina  spiralis  in  the  last  half  turn 
of  the  same.  In  this  space  the  two  scalae  are  believed  to  open,  thereby 
communicating  with  each  other. 

What  is  the  Aqueductus  Cochleae  ?  A  small  canal  which  begins  by  a 
small  orifice  in  the  lower  wall  of  the  scala  tympani,  and  runs  in  the  inner  wall 
of  the  jugular  fossa,  ending  at  the  edge  between  the  inferior  and  inner  surfaces 
of  the  petrous  portion  of  the  temporal  bone.  It  transmits  a  vein  from  the 
cochlea  to  the  jugular  vein. 

What  Parts   are   comprised   in   the   Membranous   Labyrinth?     It 

consists  of  two  membranous  sacs,  the  Utricle'^  and  Saccule,"^  which  lie  in 

the  vestibule,  together  with  the  Metnbranous 
Fig.  110.  Semicircular  Canals,^  and  the  Membranous 

Cochlea.^ y  ^  The  utricle  and  saccule  com- 
municate with  each  other  indirectly  by  a 
small  canal  contained  in  the  aqueductus 
vestibuli.  The  saccule  communicates  with 
the  membranous  cochlea  by  the  Canalis  Re- 
uniens,^  and  the  membranous  semicircular 
canals  open  into  the  utricle;  so  that  the 
membranous  labyrinth  presents  an  uninterrupted  channel  for  the  endolymph 
which  it  contains. 

What  is  the  Utricle  ?  It  is  a  flattened,  elliptical  membranous  sac,  fastened 
to  the  inner  wall  of  the  vestibule  in  the  fovea  semi-elliptica.  It  is  filled  with 
endolymph,  nearly  surrounded  by  perilymph,  and  communicates  with  the 
saccule  through  the  small  tube  in  the  aqueductus  vestibuli.     The  membranous 


THE   INTERNAL   EAR.  223 

semicircular  canals  open  into  it  by  5  orifices.     The  wall  of  the  utricle  has 
attached  to  it  the — 

Otoliths,  or  Ear-stones, — a  powder,  consisting  of  crystals  of  carbonate  of 
calcium,  -^^'^  ^°  W{F(7  ^^*-^  ^"^  diameter,  held  together  by  a  mucoid 
substance. 
Macula  Acoustica, — See  below,  under  Saccule. 

Describe  the  Membranous  Semicircular  Canals.  They  are  3  canals, 
having  the  same  shape  as  the  osseous  ones  in  which  they  are  contained,  being 
fastened  thereto  by  their  convex  curves,  and  elsewhere  surrounded  by  peri- 
lymph, except  at  the  ampullae,  where  they  fill  the  osseous  canals.  They  open 
into  the  utricle  by  5  orifices. 

What  is  the  Saccule  ?  It  is  a  flask-shaped,  membranous  sac,  about  -^^ 
inch  in  diameter,  attached  at  one  point  to  the  utricle,  and  also  to  the  fovea 
hemispherica  of  the  vestibule,  being  elsewhere  surrounded  by  perilymph,  and 
containing  endolymph.  It  communicates  with  the  utricle  through  the  small 
canal  in  the  aqueductus  vestibuli,  and  also  with  the  membranous  cochlea  by 
its  neck,  the — 

Canalis  Reuniens, — about  ^^  inch  long  and  y^^  inch  in  diameter,  is  V- 
shaped,  its  arms  opening  respectively  into  the  saccule  and  the  vestibular 
end  of  the  membranous  cochlea. 
Macula  Acoustica, — is  a  dense,  circular  point,  -^-^  inch  in  diameter,  on  the 
wall  of  both  the  utricle  and  the  saccule,  formed  by  a  thickening  of  the 
connective  tissue  where  the  fibres  of  the  vestibular  nerve  enter  it. 

Describe  the  Membranous  Cochlea.  This  portion  of  the  membranous 
labyrinth,  also    called    the  Ductus  Fig.  m. 

Cochlearis,  commences  in  the  lower 
end  of  the  osseous  cochlea  and  send 
at  its  summit  in  a  closed  extremity. 
It  is  attached  on  one  side  to  the 
lamina  spiralis,  on  the  other  side  to 
the  outer  wall  of  the  osseous  cochlea. 
It  is  formed  by  the  Membrana 
Basilaris^  below,  the  Membrane 
of  Reissner  *  on  one  side,  and  the 
periosteum  of  the  cochlear  wall  on 
the  outer  side,  its  cross  section  being 
of  a  triangular  form.  It  is  filled  with  endolymph,  and  contains  the  Organ 
of  Corti^  covered  by  the  Membrana  Tectoria.^'^     The — 

Limbiis  Lamina  Spiralis, — is  the  soft  structure  on  the  edge  of  the  lamina 
spiralis,  and  lies  in  the  membranous  cochlea.     It  has  two  lips, — an  upper. 


224 


VISCERAL  ANATOMY. 


or  Labium  Vesiibulare,  a  lower,  or  Labium  Tympanicum,  with  a  furrow 
between  them,  called  the  Sulcus  Spiralis  Internus. 
Membrane  of  Reissner,^ — extends  from  the  edge  of  the  lamina  spiralis  to 
the  outer  cochlear  wall,  forming  the  vestibular  wall  of  the  membranous 
cochlea.     Its  outer  insertion  is  the  Angulus  Vestibularis. 
Membrana  Basilaris,^ — is  the  tympanic  wall  of  the  membranous  cochlea, 
extending  from  the  labium  tympanicum  of  the  lamina  spiralis  to  the  outer 
cochlear  wall,  where  its  insertion  is  called  the  Ligamentum  Spirale,  ^  or 
Muscle  of  Todd  and  Bowman.     On  it  rests  the  Organ  of  Corti^^ — cov- 
ered by  the  — 
Membrana   Tecloria,^^ — extends  parallel  to  the  membrana  basilaris  from 
the  labium  vestibulare  to  the  outer  cochlear  wall,  where,  according  to 
some  authorities,  it  is  inserted,  according  to  others  it  is  free  and  rests 
directly  on  the   organ  of  Corti,  perhaps  to   act  as   a  damper  to  its 
vibrations. 
Describe  the  Organ  of  Corti.     It  is  a  peculiar  arrangement  of  cartilagi- 
nous rods  and  epithelial  hair  cells,  which  is  supposed  to  constitute  the  essential 
organ  of  hearing.^     It  lies  on  the  membrana  basilaris  ^  and  is  covered  by  the 
membrana  tectoria.  ^  ^     The — 

Rods  of  Corli, — are  arranged  in  two  rows,  resting,  by  their  pedestals,  on  the 
jPjg  JJ2.  membrana  basilaris,  and  uniting  with  each  other 

by  their  heads,  so  as  to  form  an  arched  tunnel  all 
along  the  membrane.     Number  of  rods  in  inner 
row  about  6,000,  in  outer  row  4,500.     Average 
diameter  of  the  rods,  from  ^^^0^  to  ^3^75-5  inch. 
Head-plates, — are  attached  to  the  heads  of  the  inner 
rods,  for  the  reception  of  the  rods  of  the  opposite 
row. 
Lamina  Reticularis,"^ — a  perforated  delicate  membrane  which  extends  from 
Fig.  113.  the     articulations    of 

2,,*^  the  rods  outwards  to 

the   external   wall   of 
the  cochlea. 
Auditory    Cells, "^ — are 
epithelial      structures 
covering     the     inner 
surfaces  of  the  walls  and  the  floor  of  the  membranous  cochlea.     Those 
which  cover  the  inner  rods  by  a  single  row  number  about  3,300,  are  nu- 
cleated, covered  with  tufts  of  cilia,  and  called  the  Inner  Hair-cells.     On 
the  outer  rods  are  3  or  4  rows  of  similar  cells,  numbering  about  18,000, 
and  named  the  Oiiter  Hair-cells, 


THE  INTERNAL  EAR.  225 

Rings  and  Phalanges,'^ — are  very  minute  structures  which  connect  the 
cilias  of  the  hair-cells  together,  and  form  the  Lamina  Reticularis.  (See 
page  224.) 

Describe  the  Origin,  Course  and  Distribution  of  the  Auditory 
Nerve.  The  8th  Cranial  Nerve,  or  Portio  Mollis  of  the  7th  pair,  arises  by 
two  roots  from  the  medulla  oblongata,  one  from  the  floor  of  the  4th  ventricle, 
the  other  from  a  nucleus  in  the  processus  e  cerebello  ad  medullam.  It  winds 
around  the  restiform  body,  from  which  it  receives  fibres,  and  emerges  at  the 
lower  border  of  the  pons,  in  company  with  the  facial  nerve.  The  two  nerves 
pass  into  the  internal  auditory  canal,  at  the  bottom  of  which  the  auditory  nerve 
divides  into  two  branches,  the  vestibular  and  cochlear  nerves.     The — 

Vestibular  JVen/e, — has  a  ganglionic  swelling  on  it  in  the  internal  auditory 
canal,  and  then  divides  into  3  branches,  which  pass  through  the  maculae 
cribosDs,  and  are  distributed  to  the  utricle,  saccule,  and  the  ampullae  of  the 
semicircular  canals,  respectively. 
Cochlear  Nerve, — gives  off  a  small  branch  to  the  wall  between  the  utricle 
and  saccule,  and  then  divides  into  numerous  filaments  which  pass  through 
the  small  canals  into  the  modiolus,  to  form  a  plexus  between  the  two 
plates  of  the  lamina  spiralis,  from  which  filaments  pass  through  the  lower 
edge  of  the  lamina  to  terminate  in  the  spindle-shaped  cells  of  the  organ 
of  Corti.  (See  page  224.) 
Intumescentia  Ganglioniformis  Scarpa, — is  the  ganglionic  swelling  on  the 

vestibular  nerve  in  the  internal  auditory  canal. 
Ganglion  Spirale, — is  a  ganglion  found  on  each  filament  of  the  cochlear 
nerve,  just  as  it  enters  between  the  plates  of  the  lamina  spiralis. 

What  Arteries  supply  the  Labyrinth  ?     The — 

Internal  Auditory  Artery,  br.  of  the  basilar  (from  the  vertebral), — accom- 
panies the  auditory  nerve  into  the  internal  auditory  canal,  where  it  divides 
into  vestibular  and  cochlear  branches. 

Stylo-mastoid  Artery,  br.  of  the  posterior  auricular  (from  the  external  carotid), 
— sends  some  small  branches  to  the  internal  ear. 

Describe  the  Internal  Auditory  Canal.  It  begins  by  a  large  orifice  on 
the  posterior  surface  of  the  petrous  portion  of  the  temporal  bone,  and  runs 
outwards  for  ^  inch,  to  end  in  a  blind  fossa,  the  floor  of  which  is  marked  by 
4  depressions,  which  are  perforated  by  fine  foramina,  for  the  passage  of  the 
filaments  of  the  auditory  nerve  to  the  labyrinth.  One  of  these  depressions  is 
the— 

Tractus  Spiralis  Forminosus, — a  spiral  shaped  depression  containing  a 
number  of  the  above  foramina,  situated  opposi     the  base  of  the  cochlea. 

Macules  Cribosce, — are  the  other  3  depressions. 
o 


226  VISCERAL  ANATOMY. 

HERNIA. 

What  is  a  Hernia  ?  A  protrusion  of  any  viscus  from  its  natural  cavity. 
The  term,  when  unqualified  as  to  the  viscus,  is  understood  to  mean  a  protru- 
sion of  the  intestines  or  mesentery,  or  both,  from  the  abdominal  cavity. 

Name  the  Herniae  of  most  importance  anatomically. 

Oblique  Inguinal  Hernia, — in  which  the  protrusion  follows  the  spermatic 
cord  through  the  inguinal  canal ;  passing  to  the  outer  side  of  the  epigastric 
artery,  and  through  both  the  internal  and  external  abdominal  rings. 

Direct  Inguinal  Hernia, — occurs  at  Hesselbach's  triangle,  escaping  to  the 
inner  side  of  the  epigastric  artery,  and  through  the  external  abdominal  ring 
only. 

Femoral  Hernia, — in  which  the  protrusion  descends  through  the  femoral  or 
crural  canal. 

INGUINAL  HERNIA. 
Where  is  the  Inguinal  Canal  1  It  is  a  passage  in  the  abdominal  wall, 
parallel  to  Poupart's  ligament,  and  just  above  it.  It  commences  at  the  internal 
abdominal  ring  ^  and  ends  at  the  external  abdominal  ring,^  being  about  ly^ 
inch  in  length.  It  serves  for  the  passage  of  the  spermatic  cord  in  the  male, 
and  the  roundj  ligament  of  the  uterus  in  the  female ;  and  is  directed  down- 
wards and  inwards.     The — 

Internal  Abdominal  Ring,^ — is  an  oval  opening  in  the  transversalis  fascia, 
formed  by  the  prolongation  of  this  fascia  around  the  cord,  as  the  infundi- 
buliform  fascia.  It  lies  ^  inch  above  Poupart's  ligament  and  midway 
between  the  anterior  superior  spine  of  the  ilium  and  the  spine  of  the 
pubes.  It  is  bounded  above  and  externally  by  the  arched  fibres  of  the 
transversalis  muscle;  below  and  internally  by  the  epigastric  vessels. 
External  Abdominal Ring,^ — is  a  triangular  opening  in  the  aponeurosis 
of  the  external  oblique  muscle,  situated  just  above  and  external  to  the 
crest  of  the  pubes.  It  is  about  l  inch  long,  and  y^  inch  wide,  and  is 
bounded  laterally  by  its  own  margins,  called  the  Internal  *  and  Exter- 
nal *  Pillars  of  the  ring.  From  these  margins  is  given  off  the  Inter- 
columnar  Fascia,  around  the  cord  and  testis. 

What  are  the  Boundaries  of  the  Inguinal  Canal  "> 
Anteriorly y — the  Skin,  Superficial  fascia.  External  oblique  muscle,  and  the 

Internal  oblique  for  its  outer  one-third. 
Posteriorly, — the  Conjoined  tendon,  Transversalis  fascia,  Triangular  ligament, 

Sub- peritoneal  tissue,  and  Peritoneum. 
Above, — the  arched  fibres  of  the  Internal  oblique  and  Transversalis  muscles. 
Below, — Poupart's  ligament,  and  the  Transversalis  fascia. 


INGUINAL   HERNIA. 


227 


The  Crural  Arch  or  Poupart's  Liga- 
Fig, 114. 


What  is  Poupart's  Ligament  ? 
ment  is  that  portion  of  the  aponeu- 
rosis of  the  external  oblique  muscle  \ 
which  extends  from  the  anterior 
superior  spine  of  the  ilium  to  the 
spine  of  the  pubes.  Its  lower  por- 
tion 3  forms  the  external  pillar  of 
the  external  abdominal  ring,i  and 
its  reflection  along  the  pectineal  line 
is  called  Gimbernafs  Ligament.'^ 
Other  fibres,  reflected  behind  the 
internal  pillar  of  the  ring,*  upward 
to  the  linea  alba,  are  termed  the 
Triangular  Ligament. 

What  is  the  Relation  of  the 
Epigastric  Artery  to  the  Internal 
Abdominal  Ring  ?  The  Epigas- 
tric artery  lies  between  the  trans- 
versalis  fascia  and  the  peritoneum, 
passing  obliquely  upwards  and  in- 
wards along  the  lower  and  inner 
margins  of  the  internal  ring.^ 

What  is  the  Cremasteric  Fascia  ?  It  consists  of  a  series  of  muscular 
loops,  united  by  areolar  tissue,  and  forming  a  thin  covering  over  the  spermatic 
cord.  The  muscular  fibres  (Cremaster  muscle)  are  supposed  to  have  been 
originally  part  of  the  Internal  oblique  muscle,  but  carried  down  by  the  testicle 
in  its  descent  to  the  scrotum.     It  does  not  exist  in  the  female. 

Name  the  Coverings  of  Inguinal  Hernia.  In  the  oblique  form  of 
Inguinal  Hernia  the  coverings  are — 

1.  Skin. 

2.  Superficial  Fascia^ — 2  layers. 

3.  Intercolumnar  Fascia, — from  the  external  abdominal  ring. 

4.  Cremasteric  Fascia, — from  the  inguinal  canal. 

5.  Infundibuliform  Process  of  the  transversalis  fascia, — from  the  internal 

abdominal  ring. 

6.  Peritoneum, — the  proper  hernial  sac. 

In  the  direct  form  of  Inguinal  Hernia,  the  coverings  are  precisely  the  same, 
except  that  the  Conjoined  Tendon  is  substituted  for  the  Cremasteric  fascia, 
and  the  Transversalis  Fascia  for  its  Infundibuliform  process. 

A  7th  covering  is  sometimes  enumerated,  viz. :  the  Sub-serous  Areolar  Tissue, 


228 


VISCERAL  ANATOMY. 


which  would  come  before  the  peritoneum  in  the  above  list.     It  is  not  suffi- 
ciently dense  to  make  an  appreciable  covering. 


FEMORAL  HERNIA. 

Where  and  What  is  the  Femoral  Canal  ?  The  Femoral  or  Crural 
Canal  lies  beneath  Poupart's  ligament,  i  close  to  the  inner  side  of  the  femoral 
vein  *  ;  and  extends  from  the  Femoral  Ring  to  the  Saphenous  Opening  in  the 
fascia  lata  of  the  thigh.  It  is  a  narrow  interval  between  the  femoral  vein  and 
the  inner  wall  of  the  Crural  Sheath  or  sheath  of  the  vessels.  The  canal  is 
}4  to  }4  inch  in  length ;  is  closed  above  by  the  Septum  Crurale,  below  by  the 
Cribriform  Fascia  ;  and  contains  only  some  loose  areolar  tissue  and  a  few 
lymphatic  vessels.     The — 

Femoral  or  Crural  Ring,—\s  an  oval-shaped  opening,  about  yi  inch  in 
Fig.  115.  diameter  (larger   in   the   female), 

situated  below  the  internal  abdo- 
minal  ring  '  and  Poupart's  liga- 
ment, ^  and  between  the  inner  side 
of  the  femoral  vein  and  the  mar- 
gin of  Gimbernat's  ligament.  ^  It 
is  closed  by  the  Septum  Crurale 
and  a  small  lymphatic  gland.  The 
arrow  in  the  figure  goes  into  the 
femoral  ring. 
Saphenous  Opening,^ — is  an  oval- 
shaped  structure,  ij4.  inch  long,  ^ 
inch  wide,  situated  below  the  inner 
third  of  Poupart's  ligament,  and 
formed  by  a  reflection  inwards  of 
the  fascia  lata  around  the  end  of  the  internal  saphenous  vein.^  The  outer 
margin  curves  over  to  the  spine  of  the  pubes,  and  is  named  the  Falci- 
form Process^  or  Ligament  of  BurnSy  its  pubic  end  being  often  called 
the  Ligament  of  Hey.  The  inner  margin  curves  upwards  behind  the 
saphenous  vein  and  under  the  outer  margin,  and  is  blended  with  the  pubic 
portion  of  the  fascia  lata  over  the  pectineus  muscle.  The  opening  is 
covered  by  the  Cribriform  Fascia. 

What  are  the  Boundaries  of  the  Femoral  Canal  ? 

Anteriorly, — Poupart's  ligament,  Transversalis  fascia,  and  the  Falciform  Pro- 
cess of  the  fascia  lata. 

Posteriorly, — Iliac  fascia,  and  Pubic  portion  of  the  fascia  lata. 

Externally, — the  Septum  covering  the  femoral  vein. 


FEMORAL   HERNIA.  229 

gttternallyy — Transversalis  fascia,  Iliac  fascia,  Gimbernat's  lijjament,  and  the 
deep  Crural  arch. 

Name  the  Structures  in  relation  with  the  Femoral  Ring.     The — 
Spermatic  Cord, — in  the  male,  lies  directly  above  its  anterior  margin,  replaced 

by  the  round  ligament  in  the  female. 
Femoral  Vein,^ — lies  next  on  its  outer  side. 
Epigastric  Artery^ — crosses  its  upper  and  outer  angle. 
Obturator  Arteryy — when  arising  from  a  common  trunk  with  the  epigastric, 

as  it  does  once  in  3^^  subjects,  may  lie  close  along  its  internal  and  superior 

margins. 

What  is  the  Septum  Crurale  ?  A  layer  of  condensed  cellular  tissue, 
supporting  a  lymphatic  gland,  and  perforated  for  the  passage  of  lymphatic 
vessels.  It  lies  across  the  femoral  ring,  and  forms  one  of  the  coverings  to 
any  hernia  escaping  thereby.  It  is  sometimes  named  the  Fascia  of  Cloquet, 
or  Fascia  of  Cooper. 

Describe  the  Crural  Sheath.  It  is  the  sheath  which  invests  the  femoral 
vessels  below  Poupart's  ligament,  and  is  formed  by  a  prolongation  of  the 
transversalis  fascia  anteriorly,  and  the  iliac  fascia  posteriorly.  It  is  divided  by 
two  septa  into  3  compartments,  the  exterior  of  which  contains  the  Femoral 
Artery,  the  middle  one  the  Femoral  Vein,  while  the  one  most  internal  is  the 
Femoral  Canal.  The  sheath  is  perforated  anteriorly  by  the  genito-crural 
nerve,  internally  by  the  internal  saphenous  vein,  and  forms  one  of  the  coverings 
of  a  femoral  hernia. 

What  is  the  Deep  Crural  Arch  ?  It  is  the  lower  thickened  border  of 
the  transversalis  fascia,  which  arches  across  the  front  of  the  crural  sheath,  and 
is  intimately  connected  therewith.  It  seems  to  be  attached  externally  to  the 
centre  of  Poupart's  ligament ;  internally  it  is  inserted  into  the  pectineal  line 
behind  the  conjoined  tendon. 

Name  the  Coverings  of  Femoral  Hernia.     From  without  inwards  its 

coverings  are  the — 

1.  Skin. 

2.  Superficial  Fascia, — 2  layers. 

3.  Cribriform  Fascia, — from  the  saphenous  opening. 

4.  Crural  Sheath, — from  the  transversalis  fascia. 

5.  Septum  Crurale, — from  the  femoral  ring. 

6.  Peritoneum, — the  proper  hernial  sac. 


VISCERAL  ANATOMY. 


THE   PERINEUM. 


What  is  the  Perineum  ?  It  is  a  triangular  space  containing  the  structures 
which  close  the  pelvic  outlet  anterior  to  a  line  drawn  between  the  tuberosities 
of  the  ischia.  Posteriorly  to  this  line  the  corresponding  space  is  named  the 
Ischio-rectal  Fossa.  The  Perineum  is  bounded  laterally  by  the  rami  of  the 
pubes  and  ischia,  anteriorly  by  the  symphysis  pubis,  and  posteriorly  by  the  line 
above  mentioned,  which  averages  about  2^  inches  in  length. 

[For  the  Muscles  of  the  Perineum,  see  antCy  p.  ^2>-\ 

THE    MALE    PERINEUM. 
What  Fasciae  are  met  with  in  the  Perineum  ?     The — 

Superficial  Layer  of  the  Superficial  Fascia, — is  thick,  loaded  with  fat,  and 
continuous  with  the  subcutaneous  fascia  of  the  thighs. 

Deep  Layer  of  the  Superficial  Fascia, — is  thin  but  strong,  continuous  in  front 
with  the  dartos  of  the  scrotum,  (?),  attached  on  each  side  to  the  rami  of  the 
pubes  and  ischium ;  posteriorly  it  joins  the  deep  perineal  fascia  under  the 
transversus  perinei  muscle.  It  sends  inwards  a  vertical  septum  which  is 
incomplete  in  front.  [This  fascia  is  called  by  Professor  Pancoast  the 
"  anterior  leaflet  of  the  triangular  ligament."] 

Anterior  Layer  of  the  Deep  Perineal  Fascia, — is  triangular  in  shape,  and 
extends  from  the  pubic  arch  and  the  sub-pubic  ligament,  laterally  to  the 
rami  of  the  pubes  and  ischia,  and  posteriorly  to  the  central  tendinous  portion 
of  the  perineum,  where  it  becomes  blended  with  the  deep  layer  of  the 
superficial  fascia.  It  embraces  the  anterior  part  of  the  membranous  portion 
of  the  urethra.  [Called  by  Professor  Pancoast,  the  "  middle  leaflet  of  the 
triangular  ligament."] 

Posterior  Layer  of  the  Deep  Perineal  Fascia, — has  the  same  attachments  as 
the  anterior  layer  above  described,  but  in  its  course  it  embraces  the  posterior 
part  of  the  membranous  portion  of  the  urethra,  and  is  in  connection  with 
the  apex  of  the  prostate  gland.  [Called  by  Prof.  Pancoast,  the  "  posterior 
leaflet  of  the  triangular  ligament."] 

Obturator  Fascia, — is  the  part  of  the  pelvic  fascia  which  covers  the  obturator 
internus  muscle,  and  is  continued  on  to  the  levator  ani  muscle  as  the  Ischio- 
rectal or  Anal  fascia. 

Recto-vesical  Fascia, — is  the  portion  of  the  pelvic  fascia  which  invests  the 
internal  surface  of  the  levator  ani  muscle,  and  the  prostate  gland,  bladder, 
rectum,  and  vesiculae  seminales. 

What  is  Buck's  Fascia  ?  It  is  a  continuation  of  the  Deep  Layer  of 
the  Superficial  Fascia  of  the  Perineum,  extending  forwards  upon  the  penis, 
and  investing  that  organ  completely  as  far  as  the  glans.     It  is  continuous  above 


THE   MALE  PERINEUM.  231 

with  the  suspensory  ligament  of  the  penis,  and  is  held  by  some  anatomists  to 
prove  that  the  deep  layer  aforesaid  is  not  continuous  in  front  with  the  dartos 
of  the  scrotum.  This  fascia  was  named  from  Dr,  Buck,  an  American  surgeon, 
who,  in  1846,  first  insisted  on  the  importance  of  this  structure.  It  modifies  the 
direction  of  urinary  infiltration  of  the  perineum,  until  perforated. 

What  is  the  Triangular  Ligament  of  the  Urethra  ?  According  to 
some  authorities  it  is  the  anterior  layer  of  the  deep  perineal  fascia ;  according 
to  others  it  includes  the  posterior  layer  also.  Prof.  Pancoast  includes  in  the 
term  "  Triangular  Ligament''^  all  three  layers  which  are  united  at  the  central 
tendinous  portion  of  the  perineum,  including,  therefore,  the  deep  layer  of  the 
superficial  perineal  fascia. 

Name  the  Structures  which  lie  between  the  Layers  of  the  Deep 
Perineal  Fascia.  In  this  space,  which  by  some  writers  is  termed  the  Cavity 
of  the  Triangular  Ligament,  are  the — 

Membranous  Portion  of  the  Urethra. 
Compressor  Urethm  Muscle.         Artery  of  the  Bulb. 
Pudic  Vessels  and  Nerve.  Nerve  of  the  Bulb. 

Cowper's  Glands  and  Ducts.         Plexus  of  Veins. 
What   Structures  lie   behind    the   Posterior   Layer   of   the    Deep 
Perineal  Fascia  ?     They  are  the — 

Bladder.  Rectum. 

Prostate  Gland.  Levator  Anti  Muscle. 

Ischio-rectaly  or  Anal  Fascia. 
Enumerate  the  Structures  situated  between  the  Anterior  Layer  of 
the   Deep   Perineal   Fascia  and  the  Deep   Layer  of  the  Superficial 
Perineal  Fascia.     They  are  as  follows,  the — 

Crura  of  the  Penis.  Erector  Penis  Muscle.  2 

Corpus  Spongiosum.  Transversus  Perinei  Muscle.^ 

Bulb  of  the  Urethra.  Transversus  Perinei  Artery. 

Accelerator  Urince  Muscle.^  Superficial  Perineal  Vessels. 

Enumerate  the  Structures  which  are  divided  in  the  Lateral  Opera- 
tion of  Lithotomy.     If  the  knife  is  inserted  i  ^  inch  above  the  verge  of  the 
anus,  and  carried  to  a  point  "^  inch  below  that  orifice,  and  about  half-way 
outwards  to  the  tuber  ischii  {^Gross)^  it  will  divide  the 
Skin  and  Superficial  Fascia  (ist  Layer). 
Inferior  Hemorrhoidal  Vessels  and  Nerves. 
Deep  Layer  of  the  Superficial  Fascia. 
Superficial  Perineal  Vessels  and  Nerves. 
Accelerator  Urincz  Muscle  ^  (posterior  fibres). 
Transversus  Perinei  Muscle  ^  and  Artery, 


232 


VISCERAL  ANATOMY. 


Anterior  Layer  of  the  Deep  Perineal  Fascia. 

Compressor  Urethm  Muscle  (a  few  fibres). 

Levator  Ani  Muscle  ^  (anterior  fibres). 

Membranous  and  Prostatic  Portions  of  the  Urethra. 

Posterior  Layer  of  the  Deep  Perineal  Fascia. 

Prostate  Gland  (in  part  only). 

Neck  of  the  Bladder. 
What  Parts  are  to  be  avoided  in  the  Lateral  Operation  of  Lith- 
otomy ?     Tliey  are  the — 

Bulb  and  its  Artery, — in  front. 
Rectum, — inwardly  and  posteriorly. 
Pudic  Artery, — outwardly. 

Fig. ii6. 


Prostate  Gland  and  Veins, — by  not  carrying  the  deep  incision  too  far  back- 
wards, the  entire  division  of  the  left  lobe  of  this  gland  will  be  avoided. 


THE  FEMALE  PERINEUM. 
What  especial  Function  does  the  Female  Perineum  Perform  ?   That 

of  supporting  the  posterior  wall  of  the  vagina,  and  thereby  aiding  materially 
in  the  support  of  the  whole  vagina,  uterus  and  bladder.     The — 

Perineal  Body, — is  the  pyramidal-shaped  prolongation  of  the  female  peri- 
neum upwards  between  the  vagina  and  rectum. 

Enumerate  the  chief  points   of  Difference  between   the    Female 
Perineum  and  that  of  the  Male.     The— 

Orifice  of  the  Vulva,  including  the  vaginal  orifice, — ^perforates  the  female 


THE  FEMALE  PERINEUM.  233 

perineum,  its  posterior  commissure  approaching  the  anal  margin  within 

about  an  inch. 
Superficial  Fascia, — is  incomplete,  by  reason  of  its  perforation  by  the  orifice 

of  the  vulva,  but  consists  of  two  layers,  as  in  the  male. 
Deep  Perineal  Fascia, — being  also  perforated  by  the  vagina,  is  less  apparent 

than  in  the  male,  though  presenting  two  layers,  with  the  urethra  perforating 

them,  as  in  the  other  sex. 
Muscles, — the  Sphincter  Vaginae  takes  the   place,  in  the   female,  of  the 

A.ccelerator  Urinse  of  the  male. 
Prostate  Gland  is  wanting, — but  its  place  is  occupied  by  a  number  of  minute 

glands  disposed  around  the  neck  of  the  bladder. 


APPENDIX  TO  POTTER'S  ANATOMY. 


TABLES  AND  PLATES 

OF  THE 

ARTERIAL   AND    NERVOUS 
SYSTEMS. 


ABBREVIATIONS. 

Anas Anastomoses.  Inf. Inferior. 

Ant Anterior.  Int Internal. 

Art.  or  A.  .  .   .  Artery.  L Left. 

Asc Ascending.  M Middle. 

Br Branch.  N Nerve. 

Cerv Cervical.  PI Plexus, 

Com Common.  Post Posterior. 

Commun.  .   .   .  Communicating.  R Right. 

Desc Descending.  Sup Superior. 

Ext External.  Superf.  ....  Superficial. 

Trans Transverse. 


Note  —The  arteries  in  the  following  plates  should  be  colored  red,  by  painting 
them  over  with  ordinary  crimson  ink,  or  water-color  paint,  using  a  fine  camel's- 
hair  brush  for  the  purpose. 


Copyright,  1890,  by  P.  Blakiston,  Son  &  C: 


Pulmonary  Artery, 
(Plate  I.) 


ARTERIAL  SYSTEM. 

THE  ARTERIAL  SYSTEM. 


{•: 


Pulmonary  Art.  (Plate 
Pulmonary  Art.  (Plate 


J  Nu 
J      c 


merous  branches  through- 
out the  pulmonary  tissue, 
carrying  Venous  blood. 


R.  Coronary  K^  ^j^^  muscular  tissue  of  the  heart. 
L.  Coronary J 

r  R.  Common  Carotid  |  ^■^'-  <^^^oitd{3). 
^Int.  Carotid  {/[). 

Innominate  -!  f  Vertebral  (5). 

R.  Subclavian  I  Thyroid  Axis  {6). 

becomes  ^;rz7/ar)' (9)]  ^«^-  Mammary  (7). 
\  Sup.  Intercostal  (8). 

L.  Common  Carotid,  .  .  Same  as  R.  Common  Carotid. 
L.  Subclavian,  .  .  Same  as  R.,  continuing  as  Axillary  (9). 


Arch  of  Aorta. 
(Plate  I.) 


External  Cairotid. 
(Plate  I.) 


Lingual. 


{Hyoid,  along  lower  border  of  os  hyoides. 
Super/.  Descending,  crosses  Com.  Carotid. 
Sup.  Laryngeal,  to  larynx  and  epiglottis. 
Inf.  Laryngeal,  crosses  Crico-thyroid  membr. 

['  Hyoid,  along  upper  border  of  bone. 

Dorsalis  LingucE,  to  tongue,  tonsil,  palate,  etc. 
Sublingual,  to  gland,  mouth,  gums. 
Ranine,  under  surface  of  tongue,  to  tip. 

Inf.  {Asc.)  Palatine,  {f ''•  *°  ^°^  P^^^*^" 
^Br.  to  tonsil. 

Tonsillar,  to  tonsil  and  root  of  tongue. 

Submaxillary,  to  gland,  skin,  muscles. 

^  ,         .  ASuperf.  Br.  anas.  inf.  labial. 
u  men  a  ^  ^^^^  ^^  ^^  ^^^  ^.^ 

Muscular,  to  pterygoid,  masseter,  buccinator. 

Inf.  Labial,  anas,  with  br.  of  7th  and  5th  N. 

Inf.  Coronary,  anas,  with  br.  of  inf.  dental  art. 

„  ^    _  { Art.  of  Septum  Nasi. 

Sup.  Coronary,  -J  _     ^      ,      r 

•"  K  Br.  to  ala  of  nose. 

Lateralis  Nasi,  to  ala  and  dorsum  of  nose. 

Angular,  termination  of  facial  trunk. 

Muscular,  to   digastric,    stylo-hyoid,    sterno' 

mastoid,  etc. 
Auricular,  to  back  part  of  concha. 
Inf.  Meningeal,  to  dura  mater  in  post,  fossa. 

{Superf.  Br.  anas,  superf. 
cervical. 
Deep  Br.  anas,  vertebral, 
and  deep  cerv.  br.  of  sup. 
intercostal. 


Facial. 


Occipital.    - 


Plate.l. 


,:^atemiu 


l/'^H^^ 


Pottei;  de 


238 


ARTERIAL  SYSTEM. 


THE  ARTERIAL  SYSTEM. -Continued. 


External 

Carotid. 
{Continued.) 


Post.  Auricular. 


Ascending 

Pharyngeal. 


Temporal. 


Internal 
Maxillary 
Divisions : 
/.  Maxillary. 

2.  Pterygoid. 

3.  Spheno- 
maxillary. 


Branches  (small),  to  muscles  and  glands. 

{anas,  with  Tympanic  of  Int. 
Maxil.  forming  vascular  cir- 
cle around  tympanum. 
Auricular,  to  cartilage  of  ear. 

External  Branches,  to  muscles  and  nerves. 
Meningeal  Branches,  to  dura  mater. 
Pharyngeal  Branches,  3  or  4  in  number. 

Transverse  Facial,  lies  on  the  masseter. 
Anterior  Auricular  Branches,  to  pinna,  etc. 
Middle  Temporal,  supplies  that  muscle. 
Anterior  Temporal.  Its  brs.  directed  backward. 
Posterior  Temporal,  along  side  of  head. 

r   ^      ,      .   (tomemb.tympani,  anas. with  Stylo« 
Tympantc\  .  ■.       K^j.\. 

t     mastoid  and  Vidian  arteries. 

Mid.  Meningeal,  to  dura  and  cranial  bones. 

Small  Meningeal,  to  dura  and  Gasserian  gang. 

I  Mylo-hyoid,  in  that  groove. 
Inferior DentalX  Incisor  X^^,^^^^^  grs. 

^-Mental,  > 

Deep  Temporal  (2),  under  temporal  muscle. 
Pterygoid  Brs.,  to  pterygoid  muscles. 
Masseteric,  to  deep  surface  of  masseter. 
Buccal,  a  small  br.  to  buccinator. 

f6w/n  Z)<?«^a/,  to  molars,  bicuspids. 
Alveolar  i  „         ,       ^    '  . 

^Branches,  to  antrum,  gums,  etc. 

Infraorbital,  has  several  brs.  in  canal. 

Post.  {Desc.)  Palatine,  to  palate,  glands,  etc. 

Vidian,  to  Eustachian  tube  and  pharynx. 

Pterygo-palatine, io  Eustach.tube  and  pharynx. 

C  Artery  ofSeptum,\.o  septum. 

Spheno-Palatine]  External  Branches  (3),  to 

or  Nasal.        1      ^^^   "^''^s-    antrum,   eth- 

1      moid  and  sphenoid  cells. 


ARTERIAL   SYSTEM. 


239 


THE  ARTERIAL  SYSTEM.-Continuid. 


Internal 

Carotid. 
(Plate  I.) 


Tympanic,  to  tympanum  by  foramen  in  carotid  canal. 
Arteria  Receptaculi  (sQveraX),  in  cavernous  sinus. 
Ant,  Meningeal,  to  dura,  anas.  mid.  meningeal. 

Lachrymal,  to  that  gland,  lid,  etc. 

Supraorbital,  the  largest  sub-branch. 

r>    ^    T-41.       -J  ,  S  Metiingeal,  io  dura.. 
Post.  Ethmoidal  i  ^,       ,  „     ' 

^^  Nasal  Brs.,  to  nose. 

Ant,  Ethmoidal,  has  same  branches. 

Sup.  Palpebral,  arch  on  margin  of  lid. 

Inf.  Palpebral,  margin  of  lower  lid. 

Frontal,  to  muscles,  skin|  ^^^.j^j^^^j 

Nasal    \  Dorsalis  Nasi,  )     Branches. 


Ophthalmic. 
Groups, 

1.  Orbital, 

2.  Ocular. 
(Plate  4.) 

Fig.  2. 


Muscular 


f  Superior,  to  ocular  muscles. 


V  Inferior,  to  ocular  muscles. 
Ant,  Ciliary,  to  circle  on  the  iris. 
Short  Ciliary,  12  or  15,  around  optic  n. 
Long  Ciliary,  to  circles  on  iris. 
Art.  Centralis  Retincs,  to  retina. 


Anterior  Cerebral  \  Ant.  Communicating,  2  lines  long. 

{  Anterior,  to  anterior  lobe  of  brain. 

Middle  Cerebrals  Posterior,  to  middle  lobe  of  brain. 

^Median,  to  the  island  of  Reil. 

_,    ^     .       ^  .    ,.       /anas,  with  Post.  Cerebral  of  Basilar,  to 

Posterior  Communicating,  \      .        ^u      •     1      r  Txrn- 
<-     form  the  circle  of  Willis. 

Anterior  Choroid,  to  the  choroid  plexus,  etc. 


THE  CIRCLE  OF  WILLIS. 


{Post.  Cerebral  \  Post.  Commun.  [   Middle    |  ^„^  Cerebral  "I 
i  I  Cerebral J 

VAnt.  Commun. 
(   Middle    ■>  .      , 

Post.  Cerebral  S  Post.  Commun.  j  cerebral  J  Cerebral  J 


240 


ARTERIAL  SYSTEM. 


THE  ARTERIAL  SYSTEM. -Continued. 


Vertebral.   - 
(Plate  I.) 


L  t      l^h'    I  i^^'  *°  spinal  cord  and  membranes. 

I  Br.  to  bodies  of  Vertebrae  posteriorly. 
Muscular  Branches,  to  deep  cervical  muscles. 
Post.  Meningeal,  ramify  between  dura  mater  and  skull. 
At     '  r  Si>'     I  |J°'"^  ^^^  fellow  to  form  Ant.  Median  Artery  of  tht 

'  t     spinal  cord. 

Posterior  Spinal,  to  spinal  cord  and  membranes,  laterally. 

r  ^    ■      ^      1.  77     i  Internal    \  to  cerebellum,  and  choroid  plexus 
Inferior  Cerebellar  ■{  ^   ^         A       .,        ,,'       ..  ^ 

■^  ^External)     of  the  4th  Ventre  e. 


Basilar.  - 


_  „      i  Auditory,  to  that  canal. 

Transverse  BrsA    .    .  ,  r  r     ■    -,  ^      i  „ 

(Ant.  {Inferior)  Cerebellar. 

Superior  Cerebellar,  to  pia  mater,  pineal  gland,  etc. 

{Post.  Choroid,\.o  choroid  plexus. 
^ra«.A..,  to  posterior  lobes  of 
cerebrum,  anas,  with  Ant.  and 
Mid.  Cerebral  Arteries. 


6. 

Thyroid 
Axis. 
(Plate  I.) 


Inferior  Thyroid.  . 


Transversalis  Colli. 


.  Supra-scapular. 


{Laryngeal,  to  posterior  muscles  of  larynx. 
J  Tracheal  Brs.  to  trachea,  anas.  Bronchial. 
1  CEsophageal  Brs.  to  oesophagus. 
yAscending  Cervical,  to  muscles,  spinal  cord. 

{Superficial  Cervical,  beneath  Trapezius. 
Posterior  Scapular,  along  post,  border. 
{Supra-acromial,  anas.  Acromial  Thoracic. 
I  Communicating,  across  neck  of  scapula. 


'  Comes  Nervi  Phrenici  {Superior  Phrenic),  to'Diaphragm. 

Mediastinal  Brs.  to  connec.  tissue,  ant.  mediastinum. 

Pericardiac  Brs.  to  upper  part  of  pericardium. 

Sternal  Brs.  to  sternum  and  Triangularis  sterni. 

Anterior  Intercostals,  to  5  or  6  upper  intercostal  spaces. 

Perforating,  to  Pectoralis  major,  mammarv  gland,  etc. 

,    ,,        .    ( Ant.  Intercostals,  to  lower  spaces. 
Musculo-phrentc  ■{  „      ^    ,  •       j-         ta-     u  * 

^  t  Brs.  to  lower  pericardium,  Diaphragm,  etc. 

anas.  Epigastric  of  Ext.  Iliac. 


Internal 
Mammary. 
(Plate  I.) 


L  Superior  Epigastric 


supplies  Rectus  abdominis,  etc. 


8.  r  Profunda  Cervicis,  ascends  along  back  of  neck,  to  axis ;  anas,  with 

Superior  J       Art.  princeps  cervicis  of  Occipital. 

Intercostal.    |    Brs.  to  ist  and  2d  intercostal  spaces,  giving  br.  to  post,  spinal  mus- 
(Plate  I.)  L      cles.  and  one  to  spinal  cord,  and  anas,  with  Aortic  Intercostals. 


ARTERIAL  SYSTEM. 


kl 


Axillary. 
(Plate  2  ) 

1  from  I  St  part. 

2  "      2d      " 

3  "      3d      " 


THE  ARTERIAL  SYSTEM  .-Continued. 

f  Superior  Thoracic,  to  Pectoral  muscles  and  wall. 

{Thoracic  Brs.  to  Pectorals. 
Acromial  Brs.  to  Deltoid. 
Descending,  to  both  these  muscle*. 

Thoracica  Longa,  to  Serratus,  Pectorals  and  gland. 
Thoracica  Alaris,  to  glands  of  axilla. 

{Subscapular. 
Infra-spinous. 
Median. 
Main  trunk  to  inf.  angle  of  the  scapula. 

f  around  neck  of  humerus,  to  Deltoid. 


Anterior  Circumflex, 
Posterior  Circumflex 


i  Br.  to  shoulder-joint. 

/around  neck  of  humerus,  to  Deltoid 


muscle  and  shoulder-joint. 
Becomes  Brachial  (io),  at  lower  margin  of  tendon  of  the  Teres 
major  muscle. 


zo. 

Brachial. 

(Plate  2.) 


Superior  Profunda, 


Post.  Articular,  to  elbow,  and  inner  side 

of  arm. 
Main    trunk,    in    spiral    groove    of    the 
L     humerus,  to  Deltoid,  Triceps,  etc. 
Nutrient,  to  nutritious  canal  of  humerus. 
InfetHor  Profunda,  to  inner  condyle  and  olecranon. 
Anastomotica  Magna,  transversely  inwards  on  Brachialis  an- 
ticus  muscle,  anas,  with  several  arteries. 
Muscular,  3  or  4,  to  muscles  in  course  of  artery. 
Bifurcates  into  Radial  (ii)  and  Ulnar  (12),  about  %  inch  below 
the  bend  of  the  elbow. 


II. 
Radial. 

(Plate  2.) 
In  forearm. 
In  wrist. 
In  hand. 


Radial  Recurrent,  anas,  branches  of  Sup.  profunda. 
Muscular  Brs.  to  muscles  on  radial  side  of  arm. 
Superficialis  Voles,  |^°  muscles  of  thumb,  anas,  with  Ulnar 
«-     Art.  completing  Superf.  Palmar  Arch. 
Ant.  Carpal,  to  wrist-joints,  anas.  Ant.  Carpal  of  Ulnar. 

Post    Carpal  |*°  wrist-joints,  anas.  Post.  Carpal  of  Ulnar. 
^  Dorsal  Interosseous,  for  3d  and  4th  spaces. 
Metacarpal,  is  the  First  Dorsal  Interosseous  Branch. 
Dor  sales  Pollicis  (2),  laterally  on  dorsum  of  thumb. 
Dorsalis  Indicts,  on  radial  side  of  index  dorsum. 

Princeps  Pollicis,  \  2  Brs.  forming  arch  on  last  phalanx. 

Radialis  Indicis,  along  radial  side  of  index  finger. 
Perforantes  (3)  between  heads  of  last  Dorsal  Interossei. 
Palmar  Interossecs  [  ^3  o""  4)  along  Interossei  muscles,  given 
<-     off  by  Deep  Palmar  Arch. 

Forms  Deep  Palmar  Arch  in  the  hand,  by  inosculating  with  the 
Communicating  from  the  Ulnar,  at  the  base  of  the  metacarpal 
bone  of  the  little  finger. 


^3 


ARTERIAL   SYSTEM. 


THE  ARTERIAL  SYSTEM.-Continued. 


13. 

Ulnar. 
(Plate  2>. 
In  forearm. 
In  wrist. 
In  hand. 


3-  i 


Interosseous 


Anterior 
Interosseous 


Anterior  Ulnar  Recurrent,  ascends  in  front  of  inner  condyle 
Posterior  Ulnar  Recurrent,  ascends  behind  inner  condyle, 
pierces  Interosseous  niera* 
brane,  descending  to  back 
of  wrist. 
Muscular  Branches. 
Nutrient,  of  both  bones. 
Br.  on  Pronator  quadratus. 
Median,  along  median  n. 
to  back  of  wrist. 
Post.   Interosseous   Recur^ 
rent,  to  ext.  condyle  of 
•  [     humerus. 

Muscular,  to  muscles  on  ulnar  side  of  arm. 

Anterior  Carpal,  to  joints,  anas.  Carpal  of  Radial. 
Posterior  Car>a/,  j'^J^^"*^  of  wrist,  anas.  Carpal  of  Radial. 
^Br.  {oxm\x\%  Post.  Carpal  Arch. 

/■anas,  with  termination  of  Radial 
Deep  {Communicating)  <     Artery,  forming  the  Deep  Palmar 


Posterior 
Interosseous 


Arch. 


Digital  (4), 


(from  convexity  of  Superf.  Palmar  Arch,  to  ulnar 
side  of  little  finger,  and  adjoining  sides  of 
ring,  middle,  and  index  fingers  (rest  supplied 
by  radial). 

Forms-  Superficial  Palmar  Arch  in  palm  of  hand,  by  inoscu- 
lating with  Superficialis  Volae  of  Radial  Artery. 


Bronchial  Arteries  (3)  nutrient  vessels  of  the  lungs. 
CEsophageal,  (4  or  5)  anas.  brs.  Inf.  Thyroid,  Phrenic,  Gastric. 
Pericardiac,  Brs.  distributed  to  the  pericardium. 


13. 

Thoracic 

Aorta. 
(Plate  3.) 


Intercostal J 

(20)  I 


r  Anterior  {Proper)\^''-  ^1°"^  lower  border  of  rib. 
y  Br.  alone  UDoer  border  of  nb. 


Br.  along  upper  border  of  rib. 

^ Spinal,  to  vertebrae,  cord,  etc. 

Posterior  {Dorsal)  \  ^^,,^1^^^  to  tissues  of  back. 

.  Posterior  Mediastinal,  (several)  to  glands,  etc.,  in  mediastinum. 


Plate  2 


■s~^ 


Totter  <3el. 


244 


ARTERIAL  SYSTEM. 


THE  ARTERIAL  SYSTEM 
Phrenic 


-Continued. 


14. 

Abdominal 

Aorta. 

(Plate  3.) 


/  Internal,  to  front  of  thorax  and  Diaphragm. 
I  External,  to  side  of  thorax. 


CCEUAC 

Axis. 


Gastric, 


Hepatic  - 


Gastro-duodenalis, 


to  cardiac  orifice  of  stomach,  cardiac 
end,  then  along  lesser  curvature  to 
pylorus,  where  it  anas,  with  Pyloric 
Br.  of  Hepatic  Art. 
'  Pyloric,  to  pylorus,  anas.  Gastric  Art. 
G  astro-  epiploic  a 
Dextra,   along 
greater   curva- 
ture. 
Pancreatico-duo- 
denalis,  to  those 
L   organs. 
.  Cystic,  br.  R.  Hepatic,  to  gall-bladder. 

Pancreaticce  ParvcB \  .^ ..  ^  ^„„^..^„o 
„  >  to  the  pancreas. 

Pancreattca  Magna  J 

Gastric  (l^asa  Previa),  5  to  7,  to  the 
Splenic    i      greater  curvature  of  stomach. 

Gastro-epiploica  Sinistra,  along  the 
greater  curvature,  from  left  to  right. 
Terminal  Brs  enter  hilum  of  Spleen. 
Inferior  Pancreatico-duodenal,  to  those  organs. 
Vasa  Intestini  Tenuis  (12  to  15)  form  arches  in 
mesentery,    in    several    series,    from    terminal 
arches  branches  ramify  on  intestines. 
Ileo-colic  I  ^^f^^^o*'^  anas.  Vasa  intes.  ten. 
I  Superior,  anas.  Colica  dextra. 
Colica  Dextra  j^^^^'  ^''- 1  Arches  branching  to 

(■Asc.  Br.   )     ascending  colon. 
Colica  Media  \  ^'^^^  \  Arches,  branching  to  trauR- 
^  Left    )     verse  colon. 
Supra-Renal,  to  supra-renal  capsule. 
Renal  i^*"^- 1°  substance  of  kidney. 

^  Small  Brs.  to  capsule,  ureter,  etc. 
Spermatic  (or  Ovarian)  to  testes  or  ovaries. 

r  Colica  Sinistra  \^J'-    \  ^'"^^^  branching  to  de- 


Superior 
Mesenteric 


^Desc.  )      scending  colon. 

1  Sigmoid,  across  Psoas  to  that  flexure  of  colon. 
Sup.  Hemorrhoidal,  \  ^J'  ^°  "^^'  }  side  of  rectum. 
^  ^Br.  to  left     J 

{fto  muscles,  etc.,  of  back. 
Dorsal  <  ,  ( Br   1  ^     , 

[Sptnal,  to  canal  j         |  Arches. 
Abdominal,  between  abdominal  muscles. 
Middle  Sacral,  to  coccyx,  anas.  Lateral  Sacral. 
Bifurcates         /Right  Com.  Iliac,  R.  Int.  and  Ext.  Iliac  (15,  16). 
1.  Left  Com.  Iliac,  L.  Int.  and  Ext.  Iliac  (15,  16). 
Bifurcation  occurs  at  4th  Lumbar  Vertebra,  opposite  Umbilicus. 


Inferior 
Mesenteric 


Lumbar  (4) 


Plate  3 


246 


ARTERIAL  SYSTEM. 


THE  ARTERIAL  SYSTEM.-Continued. 


15- 

Internal   Iliac. 

Anterior 

Trunk. 

(Plate  4.) 


r  Superior  Vesical  j^^^'  ""^  ^""^  Deferens,  to  that  organ, 
t  Middle  Vesical,  to  base  of  bladder. 
Inferior  Vesical,  to  base  of  bladder,  prostate  gland,  etc. 
Middle  Hemorrhoidal,  to  rectum,  anas,  other  hem.  arteries. 

UteHne,  to  neck  of  uterus  j  ^^^-  ^^  bladder. 

<•  Brs.  to  ureter. 
Vaginal,  analogous  to  Inf.  Vesical  in  male. 


■  In  the  female. 


Obturator. 


Internal 

PUDIC. 


Sciatic. 


Iliac,  to  iliac  bone  and  Iliacus  muscle. 
Vesical,  backwards  to  the  bladder. 
Pubic,  on  the  back  of  pubic  bone. 
Internal,  inner  margin  obturator  foramen. 
External     J^"^^*"  "largin  obturator  foramen. 
I- ^r.  to  hip-joint  by  cotyloid  notch. 

Inf.  {Ext.)  Hemorrhoidal,  2  or  3  to  anus. 
Sup  erf.  Perineal,  to  scrotum,  etc. 
Transverse  Perineal,  to  muscle  of  same  name. 
Artery  of  the  Bulb,  large  but  very  short. 
Art.  of  Corpus  Cavernosum,  to  that  body. 
,  Dorsal  Artery  of  the  Penis,  thereto. 

Muscular  Brs.  within  the  pelvis. 
Hemorrhoidal  Brs.  to  the  rectum. 
Ve.iical  Brs.  to  base  and  neck  of  bladder. 
Coccygeal,  to  back  of  coccyx. 
Inf.  Gluteal  (3  or  4)  to  Gluteus  maximus. 
Comes  Nervi  Ischiadici,  along  sciatic  nerve. 
Muscular  Brs.  to  back  of  hip. 
Articular  Brs.  to  capsule  of  joint. 


Plate  4 

FIG.   1. 


^oLachynwl  Gland 


FIG.  2. 
BRANCHES  OF  OPHTHALMIC  ARTERY. 


"^  r 

\  1 1        yyJhfJntSuraC 
MExtArtirjtlar  =^  '^ 


In/MS^ 


Potter,  del. 


248 


ARTERIAL  SYSTEM. 


THE  ARTERIAL  SYSTEM. -Continued. 


15. 

Internal   Iliac. 

Posterior 

Trunk. 


{Muscular  Br s.  within  the  pelvis. 
Nutrient,  of  the  Ilium. 
Superficial,  to  Gluteus  maximus,  etc. 
Deep  ^Superior,  to  ant.  sup.  spine  of  Ilium. 
I  Inferior,  to  glutei  and  hip-joint. 

r  Iliac,  to  Iliacus  internus  and  Ilium. 
1  Lumbar    |*°  Psoas  and  Quad,  lumborum. 

\  Spinal  Br.  to  cord  and  membranes. 

Superior  Lateral  Sacral,  to  dorsum  of  sacrum. 
Inferior  Lateral  Sacral,  to  front  of  sacrum,  and  coccyx,  anas 
with  Sacra  media,  etc. 


Ilio-Lumbar  . 


'  Muscular  Brs.  several,  to  Psoas  and  glands. 

/■  Cremasteric,  to  cremaster  muscle. 
Epigastric    -<  Pubic,  to  inner  side  of  femoral  ring. 

^Muscular,  to  abdominal  muscles  and  skin. 


x6. 

External  Iliac. 

(Plate  4.) 


Circumflex  Iliac     /^etw.  Transversalis  and  Int.  oblique. 
•^  Br.  anas,  with  Lumbar  and  Epigastric. 

Becomes  Femoral  (17)  at  Poupart's  Ligament. 


Superficial  Epigastric,  in  superf.  fascia,  to  umbilicus. 
Superf.  Circumflex  Iliac,  outwards  to  iliac  crest. 
Superf.  Ext.  Pudic,  inwards  to  skin  of  penis,  scrotum,  etc. 
Deep  Ext.  Pudic,  inwards  to  skin  of  perineum,  etc. 

{Asc.  Brs.  outer  side  of  hip. 
Transverse,  to  back  of  hip. 
Descending,  as  far  as  knee. 
{Ascending,  to  Adductors,  etc. 
Descending,  to  Adductors,  etCv 
Articular,  to  head  of  femur. 
(Superior,  pierces  Adductor  magnus, 
Middle  |  Nutrient  of  Femur. 
Inferior,  pierces  Adductor  magnus. 
Muscular  (2  to  7),  along  course  of  the  artery. 


X7. 

Femoral. 
(Plate  4.) 


Profunda 
Femoris 


Anastomotica  Magna.  [Superficial  Br.  io\n^.^^x^^n^. 

^  Deep  Br.  to  mner  side  of  Knee  and  jomt. 

Becomes  Popliteal  (18),  at  opening  in  Adductor  magnus. 


Plate  5. 


Potter,  del. 


250 


ARTERIAL  SYSTEM. 


THE  ARTERIAL  SYSTEM. -Continued. 


18. 
Popliteal. 
(Plate  4.) 


Muscular  [^^P^^or  Brs.  to  Vastus  ext.  and  flexor  muscles. 

^  Inferior  or  Sural  (7)^  to  Gastrocnemius  and  Flantans, 
Cutaneous  Brs.  to  integument  of  calf. 
Superior  Internal  Articular,  to  Vastus  int.  and  joint. 
Superior  External  Articular,  to  Vastus  ext.  and  joint. 
Azygos  Articular,  to  synovial  membrane  of  joint. 
Inferior  Internal  Articular,  to  head  of  tibia  and  joint. 
Inferior  External  Articular,  to  front  of  knee-joint. 

Bifurcates  into  /Anterior  Tibial  (19)    |      at  lower  border 
t  Posterior  Tibial  (20)  /     Popliteus  muscle. 


Recurrent  Tibial,  on  front  and  sides  of  knee-joint. 
Muscular  Brs.  numerous  to  muscles  of  leg. 
Internal  Malleolar,  beneath  tendon  of  Tibialis  anticus. 
External  Malleolar,  to  outer  ankle. 

Tarsea,  to  tarsal  joints  and  Ext.  brev.  digit. 


19. 
Anterior 

Tibial, 
(Plate  5.) 


DoRSALis  Pedis  . 


Metatarsea  \  3  InterossecB,  \     °^^^      ^' 
y  \  Dorsal  Br. 

Dorsalis  Hallucis  \  ^''-  '°  ^""^^  «^  ^^^^  t^^' 
'^  Br.  to  great  and  2d  toes. 

Communicating,    j^"^^-  ^^t.  Plantar  (Arch). 
U  Digital  Brs. 
Ends  in  the  Plantar  Arch. 


/  Anterior  Peroneal,  pierces  interosseous  membrane. 
Peroneal  X  Nutrient  of  Fibula,  to  that  bone. 

y  Muscular  Brs.  in  its  course. 
Muscular,  to  Soleus,  etc.,  on  back  of  leg. 
Nutrient  of  Tibia,  the  largest  nutrient  artery  of  bone. 
Communicating  Br.  to  the  Peroneal,  near  its  end 
Internal  Calcanean  Brs.  to  the  heel,  and  sole  of  foot. 
Internal  Plantar,  along  inner  side  of  foot. 

Brs.  to  muscles,  fascia  and  skin. 
Posterior  Perforating  (3)  Branches. 

4  Digital,  \  Ant.  Perforating  Branches. 

Ends   as  the   Plantar   Arch,  anas, 
with  Commun.  Br.  of  Dorsalis  Pedis. 


TO. 

Posterior 

Tibial. 

(Plate  5.) 


External  Plantar, 


TABLES  AND  PLATES 


NERVOUS    SYSTEM 


Note. — These  Tables  are  of  original  arrangement,  and  are  designed  to  show  the 
origin,  formation  and  distribution  of  each  nerve.  They  are  generally  self-explanatory. 
That  for  the  2d  Cranial  (Optic  Nerve)  is  too  long  for  the  width  of  the  page,  and  breaks 
at  the  Optic  Commissure,  which  is  repeated  again  where  the  table  continues  below. 

Sam'l  O-  L.  Pqttkr, 


251 


252  NERVOUS    SYSTEM. 


THE  CRANIAL  NERVES. 

r  Ethmoidal    foramina,  20, 
ist   NERVE,— Olfactory.      Funciton,— smell.      Exit,—<    in  cribriform  plate  of  Eth- 

C  moid  bone. 


^,W. /?oo/,Temp.-sphen.  lobe,\  ..      /-£jr/.i^//azw^«^j,  to  outer  wall  of  nasal  cavity. 

Mid.  Root,  Olfac.  tubercle,       >       •  r  ih  1  ^^^'  Filaments,  to  root  of  cavity. 
Int.  Root,  Gyrus  fornicat.        -'  ^Int.  Filaments,  to  Septum  nasi. 


2d  NERVE,— Optic.  Function,— %\^\..  Exit,— O^W^  foramen 


}' 


Optic  thalamus   -v  r  Longitudinal 

Corp.  geniculata  >  Fibres  -<  Decussating     ^Left  Optic  Tract 

Corp.  quad.  ant.  ^  ^Inter-cerebral 

Corp.  quad.  ant.\  (Inter-cerebral-^ 

Corp.  geniculata  [-Fibres  X  Decussating     > Right  Optic  Tract 

Optic  thalamus    ^  ^ Longitudinal   j 


Optic 

.COMMISSURE^gi^^ 

or  Chiasm.  ^^ 


Optic 
Commissure 
or  Chiasm. 


J 

{Longitudinal,  to  temporal  J4  ot  retina  >| 

Decussating,  fr.  opp.  tract  to  nasal  Yi  of  ret.    >  L.  Eye. 
Inter-retinal,  fr.  opp.  retina  to  retina  •' 


(Longitudinal,  to  temporal  ^  of  retina 

opp. 

opp. 
2d 

i  Inter-retinal,  fr.  opp.  retina  to  retina 


Optic  N.^  Decussating,  fr.  opp.  tract  to  nasal  Y^.  of  ret.    >-  R.  Eye. 


^Longitudinal,  to  temporal  Y^  of  retina. 


3d  NERVE,— Motor  Oculi.  Function— vaoWon.  .Ejtrw,— Sphenoidal  fissure. 

Corp.  quadrig.  ~| 

Valve  of  Vieus.  I       .  ^     {Sup.  Branch,  to  Lev.  palp,  sup.,  Rectus  superior. 

Aqued.  ofSyl.     |  ^        '  \lnf.  Branch    /to  Rectus  int.,  Rect.  inf.,  Inf.  oblique. 
Crus  cerebri.      J  '^  motor  root  to  Ciliary  Ganglion. 

Supplies  all  the  Ocular  muscles,  including  iris,  except  Sup.  oblique  and  Ext.  Rectus. 


4th  NERVE,— Trochlear.  Function,— moMxon.  ^'.rzV,— Sphenoidal  fissure. 

Aq.  of  Sylvius,  -v  „  ,   . 

Valve  of  Vieus.  \  4th  N.  |*°  ^"P"  Oblique  on  upper  (orbital)  surface. 

Crus  cerebri       i  Branch  to  Cavernous  Plexus  of  Sympathetic. 

Is  the  smallest  cranial  nerve,  with  the  longest  nerve-course  in  the  cranial  cavity. 


Plate  B. 


I^JVervPr  Oifiwtffry. 


Bu2b 


^ 


OlTcmtoty  Ti^ict 


OtfetctoryTilanije  rtts 


2\*^^\ert^ei-(^tir 


Corp. 


rtrochleuT- 


254 


NERVOUS  SYSTEM. 


THE  NERVOUS  SYSTEM.-Continued. 


5th  NERVE,— Trigeminus. 

(See  Page  131,  ante.) 


Functions,  Sensation,  Motion,  Special  sense. 


Origin. 

Nucleus  in  floor 
of  4th  Ventri- 
cle, and  side 
of  Pons, 
for 

Sensory  Root, 
and  the  Gang- 
lion of  Gasser. 

Nucleus  in  floor 
of  4th  Ventri- 
cle, and  side 
of  Pons, 
for 
Motor  Root. 


5th  N. 
Trigeminus, 


(i)  Ophthalmic  . 
by  Sphenoidal 
fissure. 


(2)  Superior 

Maxillary' 
by  For.  rotund. 


^ro«/a/j^"P''^°''b'tal. 

<■  Supratrochlear. 
Lachrymal. 

Ganglionic. 

Long  Ciliary. 
Nasal.    \  Infratrochlear. 

Int.  Nasal. 

Ext.  Nasal. 

Temporo-malar.  .  inSpheno- 
Spheno-palatine.  V      max. 
Post.  Dental.       i   Foramen.- 
Mid.  Dental. 
Ant.  Dental. 

Palpebral. 

Nasal. 

Labial. 


In  Canal. 


Infra- 
orbital 


/-Palpebral,  -v 
\  Nasal.  \ 
^Labial.       3 


On 
face. 


(3)  Inferior 

Maxillary. 

by  For.  Ovale. 


Ant. 
Div. 


Mid. 
Div. 


Masseteric* 

Deep  Temporal*  |^"^-  ^''•* 
1  Post.  Br.* 

Buccal. 

yPterygotd*\^''^-^''* 
\  Ext.  Br.* 

Br.  of  Communic'n. 
Br.  of  Distribution. 

fMylo-hyoid. 
Dental  Brs. 
f  Incisor. 


LingualX 


'-Terminal 


•^  Mental. 


Post.    \  Auriculo- 
Div.  I  Temporal. 


'Ant.  Temporal. 
Post.  Temporal. 
Sup.  Auricular. 
Inf.  Auricular. 
Br.  of  Commun'n. 
to  Meat.  Auditor, 
to  articulation. 
Parotid. 


*  Motor  Branches,  going  to  the  muscles  of  mastication. 


Plate  7, 
The  Cranial  ^erve s  . 

5t>  Nerve,-Trige  minus. 


256 


NERVOUS   SYSTEM. 


THE  NERVOUS  SYSTEM  .-Continued. 


7th  NERVE,— Facial,  or  Portio  Dura.  Func Hon, —Motion. 

(See  ante,  p.  131.) 

In  auditory  canal.    Br.  to  Auditory  N. 


Origin. 

Nucleus   in 

floor  of  the 

4th  Ventricle 

and 

groove 

between 

Olivary  and 

restiform 

bodies  of 

medulla 

oblongata. 


7th  N. 
Facial 


In   Aqueduct   of 
Fallopius  .  .  . 


(Large  Petrosal,\.o  Meckel's  Ganglio.; 
Small  Petrosal,  to  Otic  ganglion. 
Ext.  Petrosal,  to  meningeal  plexus. 
Tympanic  Br.  to  ear. 


At  exit  from  the 
Stylo  -  mastoid 
Foramen 


On  the  face  .  .  . 

In    Aqueduct    of 
Fallopius  .  .  . 


Br.  to  Great  Auricular  (Cerv.  Plex.) 
Br.  to  Auriculo-Temporal  (5th), 
Br.  to  Pneumogastric. 
Br.  to  Glosso-pharyngeal. 
Br.  to  Carotid  Plexus  (Symp.). 

Brs.  to  5th  Nerve. 

{Tympanic  Nerve. 
Chorda  Tympani  Nerve. 


Near  Stylo -mas- 
toid Foramen. 


^On  the  face* 


Post.  Auricular 


'  Auricular. 
^  Occipital. 


Br.  to  Digastric. 
Br.  to  Stylo-hyoid. 
.  Lingual. 

{Temporal. 
Malar. 
Infra-orbital. 
r  Buccal. 
Cervico-facial  X  Supra-maxillary. 
y  Infra-maxillary. 


•  Forming  the  Pes  Anserinus,  or  Goose-foot,  as  these  branches  are  named. 


Plate  8 


The    GptAisriAi.  Serves. 


7^^  Nerve -Facial, or  Portia  Dura. 


O.A.F 


iTvfriLorb.  JPy 


REFERENCES. 

(.GREAT  PETROSAL,™  FORM  VJOIAN  WITH  N?5. 

2.  SMALL  PETROSAL, TO  OTIC   GANGLION, 

3.  EXTERNAL  PETROSAL  JO  PLEXUS  ON  MID.  MENINGEAL  ARTERY. 

4.  TYMPANIC  BR.  TO  STAPEDIUS,  ETC. 

5.  BR.  FROM  CAROTID   PLEXUS,  MAKING  VIDIAN,  WITH  N9  I 
6.7.  BRS.TOAURICULO-TEMPORAL  OF  STV 

8.BR  TOAURICULAR   OFVAGUS. 

M.  THE  GANGLION    OF  MECKEL. 

O.A.F.    ORIFICE  OFAQUEDUCTUS  FALLOPK. 


iioLS^ 


258 


NERVOUS   SYSTEM. 


THE  NERVOUS  SYSTEM. -Continued. 


The  Eighth  Pair  (Willis)  includes  the  9th  Glosso-pharyngeal,  loth  Pneumo* 
GASTRIC,  and  nth  Spinal  Accessory,— all  of  which  Exit  by  i\\^  Jugular  Foramen,  of 
Foramen  Lacerum  Posterius. 


gtb  NERVE, — Glossopharyngeal.       Functions, — Motion,  Sensation,  Special  Sense, 


(See  ante,  page  132.) 


Origin. 
A  Gray  nucleus  in 
floor  of  4th  Vent. 

and 

medulla  oblong. 

behind  the 

olivary  body. 


gth  Nerve 
Glosso- 
pharyngeal. 


Tympanic. 
(Jacobson's  N.) 


Communica 


f  Large  Petrosal. 
<  Small  Petrosal. 


ting  Brs.  to   (carotid  Plexi 


Distributing  [ 


Fenestra  ovalis. 


Brs.  to 


Fenestra  rotunda. 
Eustachian  tube. 
Carotid  Branches. 

Pharyngeal  Brs. — to  Pharyngeal  Plexus. 
Muscular  Brs. — to  muscles  of  pharynx. 
Tonsillar  Brs.— to  Tonsillar  Plexus. 
Lingual  Brs.— to  post.  %  of  tongue,  giving  taste 
thereto. 


loth  NERVE,— Pneumogastric,  or  Vagus. 
(See  ante,  page  132.) 


/^««c^wM J,  (Sensation, 
t  Motion. 


Origin. 
A  nucleus  in  the 
floor  of  4th  Vent- 
ricle below  that 
of  9th  nerve 
and 
groove  between 

olivary  and 

restiform  bodies 

of  medulla. 


loth  Nerve 
Vagus. 


'  Auricular  {Arnold's  Nerve). 
Pharyngeal. 

Sup.  Laryngeal \^^^-  ^^• 
I  Int.  Br. 

Recurrent  or  Inf.  Laryngeal 

Cervical  Cardiac. 

Thoracic  Cardiac. 

Ant.  Pulmonary. 

Post.  Pulmonary. 

Gastric.   Intestinal. 

Hepatic.  Renal.  Splenic. 


'  Probably  comes 
from  the  Spinal 
Accessory,  and 
supplies  all  the 

laryngeal 
muscles  except 
crico-thyroid. 


Terminal  Brs. 


Gives  sensation  to  external  ear  and  larynx,  motion  to  other  parts,  also  vaso-motorial, 
inhibitory,  trophic  and  secretory  influences.  A  nerve  of  deglutition,  phonation,  respi- 
ration, circulation,  and  digestion.  The  Auriculo-Laryngo-Pharyngo-CEsophago- 
Tracheo-Pulmono-Cardio-Gastro-Hepatic-Intestinal-Renal-Splenic  Nerve. 


nth  NERVE,— Spinal  Accessory. 


Function, — Motion. 


(See  ante,  page  132.) 


Origin. 
The  floor  of  4th 
Ventricle,   and 
gray  horn  in 
cord,  down  to 
6lh  Cervical  N. 


nth  Nerve 


Branch  to  Vagus,  ganglion  of  root. 

Internal,  anastomosing  with  Vagus,  is  probably 
the  Recurrent  Laryngeal  Br.  of  the  latter  nerve. 


ExternaL  or  Muscular,  to 


f  Sterno-mastoid. 


^^Trapeziur. 
A  motor  nerve  to  the  muscles  named,  also  probably  to  the  laryngeal  also. 


Plate  9. 

The  Cranial  Xep^ves. 

■r  The  8tti  Pair  of  Nerves, 

^sy  comprising  the 

9^'^  or  Glosso-  pharyngeal, 
10^^  or  Pneumogastric, 


ll^'^or  Spinal  Accessory 


,ft-^^^-^^^ 


ffuscles  ofjjaiynx 


toOmUaein. 


/nmCTKirunlJC 


REFERENCES. 

1.  JUGULAR  GANGLION  OF  S^r  HERVE. 

2.  PETROUS  GANGLION  OF  9^"  NERVE. 
3. GANGLION  OF  THE  VAGUS  ROOT. 

'». GANGLION  0FTHEVA6US  TRUNK. 
5.  MEDULLARY  PART  OFIIT"  NERVE. 
6.SPINALPART0F  II^h  NERVE. 

7.  SUP  CARDIAC  BR.  JOINING  CARDIAC  OF  SYMPATHETIC. 
8    SUBCLAVIAN  ARTERY,  ON  RICHTSIDE,ARCH  OF  THE 
AORTA.ON  LEFTSIDE  OFTHF  BODY. 

9.  FORAMEN  MAGNUNI,RECE1VIN6  SPINAL  PART  OF 

THE  SPINAL  ACCESSORY. 

10.  JUGULAR  FORAMEN  TRANSMITTING  AILTHREE  NERVES 

<SEEANTE,FAGE3  5),ALS0  CALLED 
THE  FORAMEN  LACERUMPOSTERIUS. 
I  L  BRANCHES  TO  HYPOGLOSSAL.SYMPATHETIC 

CERVICAL  NERVES. 
I2.0LIVARY   BODY.  (IN  BROKEN  LINEl. 

Potter,  del. 


v^nif?. 


reTnunal£i7f. 


260 


NERVOUS   SYSTEM. 


THE  NERVOUS  SYSTEM. -Continued. 


6th  NERVE,— Abducens  (See  ante,  page  131). 


Origin. — Same    as  7th, 
a  gray  nucleus  in  floor 
of  4th  Ventricle, 
and 

lower  border  of  Pons. 


6th  Nerve,  Abducens. 


/-wnc/WM,  I  Motion   to   Ext 
<•     Rectus  of  Eye. 

Exit  by  sphenoidal  fissure  be- 
tween the  two  heads  of  the 
Ext.  Rectus  muscle  of  the 
eye. 

No  branches. 


8th  NERVE,— Auditory,  or  Portio  Mollis  of  the  7th  Pair. 

Function, — Special  Sense. 


Origin. — Striae  in  floor 
and  anterior  wall  of 
the  4th  Ventricle, 

and 

winds  around  the 

restiform  body. 


8th  Nerve 
Auditory. 


f  2  Semi-circ.  canals. 
Vestibular,  to-<  Utricle. 
^Saccule. 

/  Post.  S.-C.  canal. 
Cochlear,  to   -<  Saccule — Utricle  Wall. 

'•Cochlea,  and  Organ  of  Corti. 


A  nerve  of  special  sense  (hearing),  fully  described  on  page  225,  ante.  Its  Exit  is 
by  the  Internal  Auditory  Meatus,  through  the  Internal  Auditory  Canal,  to  the  internal 
ear.    It  is  the  only  cranial  nerve  which  does  not  leave  the  cranial  wall. 


xath  NERVE,— Hypoglossal  (Nonus  or  9TH  of  Willis). 

Function, — Motor  of  tongue,  etc, 


Origin. — Nucleus  in 
floor  of  4th  Ventricle, 

and 
groove  between  the 

pyramidal  and 

olivary  bodies  of 

the  medulla. 


i2th  Nerve, 
Hypoglossal ' 


(Gustatory  of  5th. 
r      "1 
Vagus. 


Br.  to  Stemo-hyoid. 
Br.  to  Sterno-thyroid. 
Br.  to  Omo-hyoid. 
Joins  Communicans 
Noni  Nerve. 


Descendens  Noni, 


Thyro-hoid,  to  that  muscle. 

iStylo-glossus. 
Hyo-glossus. 
Genio-hyoid. 
Genio-hyo-glossUs. 


Exit,  by  Ant.  Condyloid  foramen. 


Plate  10 


The  Cranial  Ner\t^s. 

6^ Nerve,-  Ahduceiis. 


12!^  Nerve, - 

Hypoglossal. 

(Nonus  or  9*oi- Willis.) 


/.  Supreu- trochlear;  3i^ 
2  Jnfi-a.trorJiUar,  J^ 
<3.  Supra-orbilaL.J^^ 
/.  AuriciUo-temporal^f^ 

7.  MilarJ'^cf rf^ 

8.  BuceaL.J^^  7^ 

9.  Posi^trior-Auriculcu:  7i^ 


"%■ 


'to  Sterna  -hyaidt  S.  tJtyroift 
and.  Onto-  ?ifvicl' 


NERVOUS   SYSTEM. 


THE  SPINAL  NERVES,  31  PAIRS. 
8  Cervical,  12  Dorsal,  5  Lumbar,  5  Sacral,  i  Coccygeal. 
N.  B. — Read  from  the  Black  Type  outwards  to  left  and  right. 


to  muscles  and  f  Ext.  Br. 
skin  of  back.  \lnt.  Br. 


r) 


{Each  ^ 

Spinal  Nerve  L  Ant.  Division,  to 
divides  into 


J      Plexuses,  etc. 


Post.  Div.  of2d  N. 
Post.  M.  of  head,  etc. 
Complexus  Muscle. 
Skin  of  occiput. 


Post. 
Div. 


ist  Cervical  1 

Nerve.        j- 

Sub-occipital  J 


Ant. 
Div. 


Brs.  (3)  to  Recti  cap.  Muscles. 

i2  Cerv.  N. 
Vagus  N. 
Hypogl.  N. 
Sup.  Cerv.  Gang. 
_Br.  to  Occip-atloid  artic'n. 


Splenius 

Cerv.  ascendens 

Transv.-colli 

Trach-mastoid 

Complexus 

to  ist  Cerv.  N. 
Skin  of  occiput. 
Auricular. 


Ext.  Branch 
supplying 


Int.  Br.  or 
Great  Occip. 


Post. 
Div. 


2d 

Cervical 

Nerve. 


Ant. 
Div. 


Fil.  to  Sterno-mastoid  M. 
Asc.  Br.  to  ist  Cerv.  N. 
Desc.  Br.  to  3d  Cerv.  N. 
Fil.  to  Commun.  Noni  N. 
Occipitalis  Minor  Nerve. 


Integument  of)    Int.  Br, 
occiput.        j  to  supply^ 


Post. 
Div. 


3d 

Cervical 

Nerve. 


Ant. 
Div. 


{Auric.  Magnus. 
Superf.  Cervical. 
Br.  to  2d  Cerv.  N. 
Br.  to  Spinal-ac. 


Descen. 
Br. 


Fil.  to  4th  Nerve. 
Fil.  to  Lev.  ang.  scap. 
Supra-clavicular, 
Fil.  to  Com.  Noni  N. 
Fil.  to  Phrenic  N. 


Muscles  of  the  Back. 


)    Post,    f 
(    DIV.    1 


4th  Cervical 
Nerve. 


Ant. 
Div. 


Fil.  to  3d  Cerv.  N. 
Fil.  to  5th  Cerv.  N. 
Fil.  to  Phrenic  N. 
Fil.  to  Scalenus  medius. 
^Fil.  to  Supra-clavic.  N. 


Anterior 

Branches 

of 

ist  Cerv.  N. 

2d  Cerv.N. 

3d  Cerv.N. 

4th  Cerv.N. 


'  Superficial  Br. 


Cervical 
Plexus. 


f  Ascending  Set  (5)  to  head  and  shoulder. 
\  Descending  Set  (3)  Sternal,  Clavic.  Acrom. 
I  Vagus. 


^Deep  Branches 


Internal  Set 


Communica- 


\  Hypogl. 


tingto(sy^p 

Muscular. 

CoMMUNic.  Noni  Nervk. 

Phrenic  Nerve. 

External  Set  \^'''-''''^^''^'^\   .     ,  ^ 

t  Comm'g  ta  Spinal-acc.  N. 


Plate  11 


THE    SPINAL  NERVES. 
Cervical  Plexus, 


THIS  PLEXUS       LIES  UPON  THE 


SCALENUS    MEDIUS   AND 
;  LEVATOR  AN6ULI     SCAPULAE 


THE  CERVICAL    I    IS    COVERED    BY  THE    STERNO-CLEI  DO  -  MASTOID     MUSCLE. 

■p otter,  del. 


264 


NERVOUS   SYSTEM. 


THE  NERVOUS  SYSTEM. -Continutd. 


THE  BRACHIAL  PLEXUS. 


Ant.  Div.l 

5th 
Cervical 
Nerve. 

Ant.  Div. 

6th 
Cervical 
Nerve. 

Ant.  Div. 

7th 
Cervical 
Nerve. 

Ant.  Div. 

8th 
Cervical 

Nerve. 

Ant.  Div. 

I  St 

Dorsal 
Nerve. 


Outer 
Cord. 


Inner 
Cord. 


Brachial 
Plexus. 


Outer 
Cord. 


Inner 

Cord. 


Posterior 
Cord. 


'  Post.  Thoracic  N.  or 

Ext.  Respiratory  N.  of  Bell 


Muscular,  to  • 


to 

Serrat. 
mag. 
/  Supra-spinatus. 
Supra-scapular,  to  -<  Infra-spinatus. 
vShoulder-joint. 
Rhomboidei  (5, 6,  Cerv.) 
Subclavius  (5,  6,  Cerv.) 
Scaleni  (6,  7,  Cerv.) 
Long,  colli  (6,  7,  Cerv.) 
Lev.  ang.  scap.(5,  Cerv.) 
.Br.  to  Phrenic  Nerve. 

Br.  to  Posterior  Cord  of  Plexus. 
External  Ant.  Thoracic,  to  Pect.  major. 

(Muscular. 
Anterior. 
Posterior. 
Articular. 
Median  Nerve  (outer  head)  (No.  3). 

r  Scaleni  (8,  Cerv.) 
Muscular,  to  -<  Long,  colli  (8,  Cerv,) 

^    Above  Clavicle. 
Br.  to  Posterior  Cord  of  Plexus. 
Int.  Ant.  Thoracic,  to  Pectoral  muscles 
Internal  Cutaneous  (No.  5). 
Lesser  Int.  Cutan.  {N.  of  Wrisberg). 
Median  Nerve  (inner  head)  (No.  3). 
Ulnar  Nerve  (No.  7). 

ist  Subscapular,  to  Subscap.  M. 
3d  Subscapular,  to  Lat.  dorsi. 
3d  Scapular,  to  Teres  major. 
Circumflex,  to  Deltoid  and  skin. 
Muscular. 


Musculo-Spiral 
(No.  10). 


Cutaneous. 
Radial. 
.Post.  InterosseotJS. 


Note.—Nos.  1, 3, 3,  etc.,  refer  to  the  next  two  Tables. 


Brachial  Plexus 


Plate  12. 


The  Spinal  Nerves 


FxlcLnvent-  t^ 


7.  Three  ,Sub-scaMrula.rJ\/erves. 
2  Internal  <  rntShortcric. 


Intercostal. T^erve  jLJ^ZcttenU cutaneous 


\Musculo  -cuteuieous 


.  Ifuscuio-sffirul 

f/in<ir 
Intertud  -cutanJeovLS 
le^er  Inte-mai  cutaneous 


THE  BRACHIAL  PLEXUS  IS 
IN  THE  NECK  AND  THE  AXILLA, 
LYING  BETWEEN  THEANTERIOR 
AND  MIDDLE  SCALENI  MUSCLES 
AT  FIRST. THEN  BELOW  THE 
SUBCWIUSANO  UPON  THE  l?T 
SERRATION  OF  THE  SERRATUS 
MAGNUS  AND  SUBSCAPULAR! S. 
ITISONBOTHSiDESOF.AND 
BEHIND  THE  AXILLARY  ARTERY 
IN  ITS  2N9  PORTION,  EXTERNAL 
THERETO  IN  ITS  I^T  PORTION. 


366 


NERVOUS   SYSTEM. 


THE  NERVOUS  SYSTEM. -Continued. 

NERVES  OF  THE  UPPER  EXTREMITY. 
Terminal  Branches  of  the  Brachial  Plexus. 


'    (i)  External  Anterior  Thoracic,  to  Pectoralis  major. 

(Coraco-brachialis. 
Biceps. 
Brachialis  anticus. 


(2)  External  or 
Musculo- 
cutaneous. 


(3)  Median. 


Anterior  Br. 


Posterior  Br. 


Skin  of  forearm  (front). 
Skin  of  ball  of  thumb. 
Joins  Radial  Nerve. 

r  Skin  of  forearm  (back). 
I  Joins  Radial  Nerve. 
I  Joins  Ext   Cutan.  Br.  of 
I     Musculo-spiral  N. 


Articular  Br.     |  to  Elbow-joint. 


Muscular,  to . 


Anterior 

Interosseous. 


{Pronator  radii  teres. 
Flex,  carpi  rad. 
Palm,  longus. 
Flex.  subl.  digit. 

to  Flex.  long.  poll. 

to  Flex.  prof,  digit.  (Ext.  J^.) 

to  Pronat.  quadrat. 


Palmar  r  Skin  of  palm. 

Cutaneous.  \  Skin  of  ball  of  thumb. 


to  Abduct,  poll, 
to  Opponens  poll, 
to  Flex.  brev.  poll. 
Digital,  to  thumb. 
.  Digital,  to  ist  finger. 


External  Br. 


Internal  Br. . 


Digital,  to  contiguous  sides 
of  index,  middle  and  ring 
fingers. 

Filaments  to  two  outer  Lum- 
bricales. 


,.^     ^The  Spinal  Nerves. 


Plate  13 


268 


NERVOUS  SYSTEM. 


THE  NERVOUS  SYSTEM. -Continued. 


(4)  Internal  Anterior  Thoracic,  to  both  Pectoral  muscles. 

^  Anterior  Br.  to  skin  of  forearm,  inner  side. 


(5)  Internal  Cutaneous 


t  Posterior  Br.  to  skin  of  forearm,  inner  side. 


(6)  Lesser  Internal  Cutaneous, 
{N.  of  IVrisberg.) 


/■Is  < 

i ;: 


Is  often  wanting,  Intercosto-humeral  tak« 
ng  its  place,  to  post,  surface  of  lowel 
Yi  of  skin  of  arm. 


(7)  Ulnar 


Articular, 
Muscular, 
Palmar  Cutaneous.    Skin  of  front  wrist,  and  palm  of  hand. 


to    Elbow-joint. 

Flex.  carp,  t 

Flex.  prof.  dig.  (inner  %.) 


.     f  Flex.  carp,  ulnaris 


Dorsal  Cutaneous. 


Articular,  . 


Superficial  Brs. 


Skin  of  back  wrist,  and  ij^  fingers. 
Wrist-joint. 


Deefi  Brs. 


.    f  Palmaris  brevis. 
•^Skin  of  i>^  fingers. 


Muscles  of  little  finger 

Interossei. 

2  inner  Lumbricales. 

Adduc.  pollicis. 

Flex.  brev.  poll,  (inner  head). 


(8)  Subscapular  (3). 


(9)  Circumflex 


(10)   MUSCULO- 

Spiral. 


ist  upper,  to  Subscapular  muscle, 
2d  Long,  to  Latiss.  dorsi. 
3d  Lower,  to  Teres  major. 

Superior  Br  .  toj^^^toid. 

'^Skin  of  shouldw. 

f  Teres  minor. 
Inferior  Br.   .   to -<  Deltoid  (post  ). 
''Skin  ef  shoulder. 


Muscular,   . 


{Triceps,  Anconeus. 
Brach.  anticus 
Supin.  long. 
Ext.  carpi,  rad.  long. 


Cutaneous,  to  skin  of  arm. 


Radial. 


Internal  Br. 


External  Br.  to  skin  of  thumb. 

to  skin  of  z%   fingers  on 
radial  side  of  dorsum. 

{to  all  muscles  on  back  of  forearm, 
except  Anconeus,  Sup.  long,  and 
Ext.  carpi  radialis  long. 
Filaments  to  wrist-joints. 


NERVOUS    SYSTEM. 


269 


THE  NERVOUS  SYSTEM  .-Continued. 


THE  DORSAL  NERVES. 
N.  B.— Read  front  the  Black  Types  outwards  to  left  and  right. 


Transv.  colli. 
Longis.  dorsi. 
Trachelo-raast. 
Levat.  costar. 
Sacro-lumbal. 
Accessorius. 

Semi-sp.  dorsi. 
Multif  Spinae. 
Skin  of  back. 


Ext.  Brs. 
«-«  to 


\lnt. 


Brs. 
to 


Each    ■ 

Post. 
Div. 

6  Upper 

Dorsal 

.Nerves.^ 

Ant.  Div. 

Thoracic 

Intercostals 


Muscular. 


Lateral 
Cutaneous. 


Intercos. 
Tri.  Ster. 

f  Skin  of 
Chest, 
Breast, 
Side, 
Back. 


Anterior 
Cutaneous 


Skin  of 
Chest, 
Breast. 


Same  as  above.  •» 
Skin  of  back.     J 


Ext.  Brs. 


Same  as  above.  % 

No  br.  to  skin.   \  Int.  Brs. 


(Each 
6  Lower 
Dorsal 
Nerves. 


Muscular. 


f Intercos. 
t^Abdom.M 


f 


.    .       ,         ,    Skin  of 
Lateral         '  auj 
_  ^  <  Abdomen, 

Cutaneous,  i 

'■       etc. 

,   ,  <■  Recti  M. 

Antertor       \    ^^^.^  ^^ 

Cutaneous.\^^^^^ 


270 


NERVOUS   SYSTEM. 


THE  LUMBAR  AND  SACRAL  NERVES. 

(Distribution  shown  on  next  Table.) 


An 

External    Branch, 

sending  filaments 

to  the  Erector 

spinae  and 

Intertransversales 

muscles,  and  the 

skin  of  the  gluteal 

region,  posteriorly. 


An 

Internal  Branch, 
sending  filaments 

to  the  Multifid. 
spinae,  and  skin 
over  vertebrae  of 

spinal  column. 


An 

External  Branch, 
forming  loop  on 
sacrum  and  great 
Sac-Sciat.  lig.  to 
supply  skin  over 
glutei. 


An 

Internal  Branch, 

to  Multifidus  Spinae 

and  back  part  of 

coccyx. 

(the  two  lower 

nerves.) 


1st  Lumbar. 


2d  Lumbar. 


c  ^  3d  Lumbar. 


■4th  Lumbar. 


•R  Uth  Lumbar, 


ist  Sacral. 


2d  Sacral. 


Are  below  the' 
Multifid.  Spinae, 
join  together  in 
loops  over  back 
of  sacrum, 
sending  fila- 
ments to  skin. 


Post 
Div 


;] 


Post. 
Div. 


3d  Sacral. 


4th  Sacral. 


5th  Sacral. 


Coccygeal. 


{Nos. 
I,  2,  3, 
Comm.  Br. 
to  2d  Lum. 

iNos. 
3,  4,  5, 
Comm.  Br. 
to  3d  Lum. 

{Part  of 
5,  6,  7, 
Comm.  Br. 
to  4th  Lum. 


Ant. 
Div. 


Part  of 

5,  6,  7, 


Lumbo- 
sacral 
Cord 
to  5th  Lum. 

{Joins  the 
Lumbo- 
SacralCord 

Joins  the 
Lumbo- 
sacral Cord 

and 
2d  Sacral. 


(i)  nio-hypogastric 

(2)  Ilio-inguinal . 

(3)  Genito-crural. 

(4)  Ext.  Cutaneous. 

(5)  Ant.  Crural. 

(6)  Obturator. 

(7)  Accessory 

Obturator, 
(when  present.) 


Ant, 
Div. 


Ant 
Div 


..{! 


oins  with 
I  St  Sacral. 


{Joins  with 
2d  Sacral 
and  part 
of  the  4th. 

Br.  to 

Plexus, 

Vise.  Brs. 

Mus.  Brs. 

.  Fil.  to  5th. 


/-Br.  to  skin  of  coccyx. 
.'    -<  Br.  to  Coccygeus  M. 
i-Br.  toCocc.  Nerve. 


Ant. 
Div. 


(i)  Super.  Gluteal. 

(2)  Muscular  Brs. 

(3)  Small  Sciatic. 

(4)  Great  Sciatic. 

(5)  Pudic. 

(6)  Articular. 


Ant. 
Div 


{' 


delicate  filament,  going 
to  skin,  over  coccyx. 


from  /^^/^Donsal 


THE  SPINAL  SERVES. 

Lumbar  6c  Sacral  Plexuses 


Plate  14 


THE  LUMBAR  PLEXUS    lies  in  the  substance  of  the  psoas  muscle, 

ILIES  UPON  THE  PYRIFORMIS  MUSCLEINTHE  PELVIS, 

THE  SACRAL  PLEXUS  <  and  is  covered  by  the  pelvic  fascia,  and  the 

I  SCIATICAND  PUDIC  ARTERIES 

Pot:tv-i„dfci, 


272 


NERVOUS  SYSTEM. 


THE  NERVOUS  SYSTEM —Continued. 

DISTRIBUTION  OF  THE  BRANCHES 

From  the  7  Great  Trunks  of  the   LUMBAR  PLEXUS. 

(A  Continuation  of  the  Table  on  Page  288.) 


(i).  Ilio-hypogastric   .  . 
(«).  Ilio-inguinal,  .  .  .  .  , 
(3).  Genito-crural    .  .  .  . 
(4).  External  Cutaneous 


(5).  Anterior 

Crural. 


(6).  Obturator. 


Ant. 
Div. 


{Hiac,  to  skin  of  gluteal  region. 
Hypogastric,  to  skin  of  that  region. 

f  to  Internal  Oblique  Muscle. 

Ito  skin  of  upper  and  inner  thigh,  scrotum,  penis. 

f  Genital,  to  Cremaster,  scrotum,  round  ligament. 
I  Crural,  to  skin  of  upper  and  front  thigh. 

(Ant.  Br.  to  skin  of  ant.  and  outer  thigh,  above  knee. 
\Post.  Br.  to  skin  of  post,  aud  outer  thigh,  above  knee, 

to  Sartorius,  and  skin  of  ant.  thigh 
above  knee. 
/Ext.  Br.  to  skin,  lateral  of  knee. 
Int.  Cutaneous.     <  Post.    Br.  to  skin  of  inner  thigh 
'.     and  leg. 
to  Skin  of  knee  and  of  front  and 
inner  leg  and  foot. 


Mid.  Cutaneous. 


Long  Saphenous. 


Post.    (Muscular  Brs.  to  muscles  on  front  of  thigh,  all  but  2. 
Div.  <■  Articular  Brs.  (2)  to  capsules  of  knee-  and  hip-joints. 

.  f  Articular  Brs.  ioh\^-)o\ni. 

"  '    <  Muscular  Brs.  to  Adductors,  Gracilis  and  Pectineus. 
^'  ^Anastomotic  Brs.  with  Int.  Cutan.  and  Int.  Saphenous. 

Post.    (Articular  Brs.  to  knee-joint. 

Br.  \  Muscular  Brs.  to  Adduc.  mag.  and  Obturator  externus. 


f  Muscular  Br.  to  Pectineus. 
(7).  Accessory  Obturator. -<  Articular  Br.  to  hip-joiut. 

y  Cutaneous  Br.  to  skin  of  thigh  and  leg. 


I  Occasionally 
r     present. 


The  Lumbar  Plexus  lies  in  the  substance  of  the  Psoas  muscle,  in  front  of  the  trans- 
verse processes  of  the  lumbar  vertebrae. 


Plate  15 


The  Spinal  Nerves. 


£o>ter,aiil. 


274 


NERVOUS  SYSTEM. 


THE  NERVOUS  SYSTEM. -Continued. 


DISTRIBUTION  OF  THE  BRANCHES 

OF  THE  SACRAL  PLEXUS. 
[Continuation  of  Table  on  Page  288.] 


(i).  Superior  Gluteal 


(Su 
'{In 


Sup.  Br.  to  the  Gluteus  medius  and  minimus, 
to  the  Gluteus  medius  and  minimus, 
to  the  Tensor  vaginae  femoris. 


Inf.  Br. 


(2).  Muscular  Branches,  to  I  Py"^°™'^'  Obturator  internus,  the  two  Gemelli,  and 
I     the  Quadratus  femoris  muscles. 

(3).  Articular  Branches,  to  the  hip-joint. 

( Gluteus  maximus  muscle. 


(4).  Small  Sciatic. 


/«/.  Gluteal, 


I  Skin  of  side  of  penis,  or  vulva. 


Inf. Pudendal  |^^'"  of  upper  and  inner  thigh,  and  of  scrotum 
*  I     or  labium. 


(5).  Great  Sciatic. 


Cutaneous, 
Articular,  . 


/Ascending,  to  Skin  over  Glutei. 
I  Descending,  to  Skin  of  post,  thigh. 

.  to  the  hip-joint. 


Muscular,  to  (Adductus  magnus.  Biceps. 

I  Semi-membranosus,  Semi-tendinosus. 


External  Popliteal  or  Peroneal. 
Internal  Popliteal  Nerve. 


Terminal  Branches. 
{^See  next  page.) 


(6).   PUDIC. 


Perineal, 


{/•to  Skin  of  anus,  scrotum. 
Superficial  Perineal,  \     penis  and  labia,  and  the 
^     Sphincter  ani  muscle. 
Muscular,  to  perineal  muscles. 


Inferior  Hemorrhoidal, 


to  Sphincter  ani  muscle. 
to  Skin  of  anal  region. 


Dorsal  of  Penis,  |  Skin  of  dorsum  of  penis. 

I  Br.  to  Corpora  cavernosa. 

The  Sacral  Plexus  lies  in  the  pelvis  upon  the  Pyriformis  muscle,  and  is  covered  bjr 
the  Pelvic  fascia,  and  the  Sciatic  and  Pudic  Arteries. 


NERVOUS  SYSTEM. 


JTiJ 


THE  NERVOUS  SYSTEM  .-Continued. 


External 
Popliteal 

or 

Peroneal 

Nerve. 


DISTRIBUTION  OF  THE  NERVES 

OF  THE  LEG  AND  FOOT. 

[Terminal  Branches  of  the  Great  Sciatic] 

f  (i).  Articular  {i),  distributed  to  the  knee-joint. 
(2).  Cutaneous  (2  or  3),  to  skin  of  leg,  exteriorly  and  posteriorly. 

Muscular,  to  1^°"^  muscles  of  leg. 
I  Peroneus  tertius. 


(3).  Anterior 
Tibial. 


(4).  Musculo- 
cutaneous. 


c   ^         7  D     /  Extensor  brevis  digitorum. 
External  Br.  \  ^        ,       .     ,     . 

*.  Tarsal  articulations. 

//         IR      f  Skin  of  contiguous  sides  of  great  and 
^     2d  toes. 

Muscular,  .  .  \  Peroneus  longus  and  brevis. 


External  Br. 


f  Skin,  outer  side  of  foot  and  ankle. 


Skin,  contig.  sides,  3d,  4th,  5th  toes. 


/Skin,  inner  side  of  foot  and  ankle. 
Internal  Br.  X  Skin,  contig.  sides,  2d  and  3d  toes, 
'^    and  inner  side  of  great  toe. 


(i).  ^r//cM/ar  (3),  to  knee-joint. 

(2).  Muscular,  to  Gastrocnemius,  Plantaris,  Soleus,  and  Popliteus. 

(•formed  by  a  filament  from  each  of  the  Popli- 


Internal 
Popliteal   - 
Nerve. 


(3).  Ext.  Saphenous,   ■<     teal  nerves,  to  skin  of  outer  side  of  the 
'-    foot  and  little  toe. 

Muscular,  to  (flexor  longus  poUicis,  Flexor  longuis 
I     digitorum.    Tibialis  posticus. 

Plantar  Cutaneous,  to  skin  of  heel  and  sole. 

{Digital,  to  skin,  zV^  inner  toes. 
Muscular,  to  flexors,  etc. 
Articular,  to  tarsus. 
Cutaneous,  to  sole  of  foot. 

r  Muscular,  to  Flexor  accessorius. 
f\.oi%  outer  toes. 
External        ^  Superficial,  <  Flexor  brevis  min.  mg 
Plantar.  1  ( ^^^  Interosseous. 

{Deep  Br.  {^^  ^"^  ^^^  Lumbricales. 
'  1.  Rest  of  Interossei. 


Posterior 

Tibial. 


276 


NERVOUS  SYSTEM. 


THE  NERVOUS  SYSTEM. -Continued. 


THE  SYMPATHETIC  SYSTEM, 


ron  the  Anterior  Communicating  Artery. 
Ganglion  of  Ribes-<  In  it  begins  the  double  chain  of  gangliated  cords  enumcK 
'^    ated  below. 

fSome  to  Pneumogastric,  Glossopharyngeal,  and 
Hypoglossal  Nerves. 


External 

Braytches 

to  join  the 

Superior 

ISt,  2d, 

Cervical 

3d,  4th 

Ganglion 

Cervical 

Nerves. 

Ext.BrsXo 

Middle 

5th  and  6th  * 

Cervical 

Cerv.  N. 

Ganglion 

Ext.  Br.  forms  Carotid  Plexus. 


yAscend,  BrA  Int.  Br.  forms  Cavernous  Plex. 
V    along  Int.  Carotid  Artery. 
Anterior  Branches,  to  Plexus  on  Ext.  Carotid  Artery. 

(  Pharyngeal,  to  Pharyngeal  Plexus. 
Superior  Cardiac  Nerve,  to  Cardiac  Plexus; 
goes  to  Deep  PI.  on  right  side,  to  Superficiaf 
PI.  on  left  side  of  body. 


Int.  Bts. 


Filaments  along  Inf.  Thyroid  Art.  to  Thyroid 
ltd.  Brs.  A     body  and  Larynx. 

1  Mid.  Cardiac  Nerve,  to  Deep  Cardiac  Plexus. 


Ext.  Brs.  to  I     Inferior     i  J  Filaments  along  Vertebral  Art.  to  cranium. 

7th  and  8th,  \     Cervical     \  Int.  Brs.  <  ^^^  Cardiac  Nerve,  to  Deep  Cardiac  Plexus. 
Cerv.  N.         Ganglion  '- 


Ext.Brs.to 

12  Dorsal  N. 


13 

Thoracic 
Ganglia. 


Int.  Brs.   ■ 


Upper  5  or  6  to  Aorta  and  Vertebral  column. 
2d,  3d  and  4th  to  Post.  Pulmonary  Plexus. 
Lower  6  from  the  3  Splanchnic  Nerves,  thus — 
6-10,  Great  Splanchnic,  to  Semi-lunar  Gang. 
10,  II,  Small  Splanchnic,  to  Cceliac  Plexus. 
12,  Smallest  Splanchnic,  to  Renal  Plexus. 


Ext.  Brs.  to 
Lumbar  N 


Ext.  Brs. 
Sacral 


^<  Lumbar  > 

■  '^  Ganglia.  J 

^•*°|  Sacral  \  Int.  Brs.  \ 

^'    (  Ganglia.  }  ^ 


f  Some  to  Aortic  Plexus. 
Int.  Brs.  |g^^g  Jo  Hypogastric  Plexus. 


4 

Sacral 

Ganglia 

Coccygeal 
G,,  or 

Ganglion 
Impar. 


to  Pelvic  Plexus. 

to  Plexus  on  Middle  Sacral  Artery. 


In  which  ends  the  double  chain  of  gangliated  cords  enumer- 
ated above,  and  called  The  Sympathetic  Nervous 
System. 


[For  the  various  connected  Ganglia,  etc.,  see  ante,  pages  137  to  140.] 


Glosso-ph. 


The  Sympathetic 

SVSTEM  OfXeRVES. 

JrOryhon  (ff/Hdes 

~7 
Zarae  S-PetrosoL   7*^ 


Plate  16. 


G.=  GANGLION. 
P.=  PLEXUS. 
A.=  ARTERY. 

2,3.4.   BRAN  CHES. 
rROM    PNEUMOGASTRIC. 
NERVE    TO  THE  CARDIAC. 
PLEXUS. 


9astro-tUiactenai 


Si'? 

irotnCowyyoai 


3  SapMemorrhoidaL. 
6  SpermaticI'lejcus. 


JPe  I  xas  P.  or  In  t'lh/yjocfo^tric . 

'    SUPPLIES  ALL  THE  PELVIC  VISCERA  AND  THE  PENIS. 


frcLngUan  JntjHw. 


INDEX 


Note. — Titles  which  contain  the  name  of  a  person  are  entered  twice,  one  entry  being 
under  the  person's  name,  the  other  under  that  of  the  structure. 


PAGE 

ABDOMEN i6i 
Abdominal  Cavity i6i 

Regions 162 

Absorbents 119 

Acervulus  cerebri 127 

Acetabulum 41 

Adenology 9 

Alveoli II,  23 

of  the  lungs 173 

Alveolus 141 

Amphiarthrosis 55 

Ampulla  of  semi-circ.  canals 221 

of  the  milk-ducts 192 

Anastomoses 114 

Anastomosis,  The  Stirrup 113 

Anatomy 9 

Angiology 9 

Angle  of  the  jaw 28 

Visual 197 

Angulus  vestibularis 224 

Annulus  ovalis loo 

Anti-helix  213 

Anti-tragus 213 

Antrum  of  Highmore 22 

Anus 152 

Aorta 102 

Apparatus  ligam.  coUi 57 

Appendices  epiploicae 152,  165 

Appendix  auriculae 100 

Ensiform 38 

vermiformis 151 

Aponeuroses 67 

Aponeurosis,  Pharyngeal 147 

Apophysis 10 

Aqueduct  of  Sylvius 124 

Aqueductus  cochleae 17,  35,  222 

Fallopii 216 

vestibuli ifi,  35,  220 

Arachnoid  of  brain 121 

of  spinal  cord 129 

Arbor  vitae 129 

Arch,  Crural 227,  229 

Palmar 108 

Plantar •  113 

Areola  of  mammae 192 

Arm 45 

Arnold's  ganglion 137 

,      n^rve 35,  132 

Arteriae  propriae  renales 176 

Arterial  anastomoses 114 

Arteries 102 

Helicine 182 

Hepatic 155 

Lingual 145 


PAGE 

Arteries,  Pharyngeal 145 

Sub-lingual 145 

Arteries  of  the— 

ankle-joint 65 

auditory  canal 214 

auricle 214 

bone 12 

choroid 200 

elbow-joint 61 

Eustachian  tube 219 

eye 206 

eyelids 210 

hip-joint 63 

iris  202 

kidney 176 

knee-joint 63 

labyrinth 225 

larynx 170 

lung 173 

mammae 192 

membrana  tympani 215 

nasal  fossae 196 

nose 196 

oesophagus 148 

ovaries 191 

pancreas 157 

penis 183 

pharynx 147 

retina 203 

shoulder-joint 60 

stomach 150 

supra-renal  capsules i6i 

testicle 185 

thymus  gland 160 

thyroid  gland 159 

tympanum 218 

uterus 19Q 

wrist-joint 62 

Arteriolae  rectae 176 

Artery .  .      102 

Anastomotica  magna 108,  112 

Aorta 108,  109 

Art.  receptaculi 105 

Auricular 105 

Axillary 107 

Basilar 106 

Brachial 107 

Carotid 103,  104, 105 

Cerebral,  Anterior 105,  207 

Middle 106 

Choroid,  Anterior 106 

Circumflex,  Anterior 107 

Posterior 106 

Communicating,  Anterior 106 


277 


278 


PAGE 

Artery,  Communicating,  Posterior io6 

Coronary 103 

Digital 114 

Dorsalis  hallucis 113 

pedis 113 

Epigastric 11 1,  227 

Superficial 112 

Facial 104 

Femoral iii 

Gastric 109 

Gluteal Ill 

Hemorrhoidal  no 

Hepatic 109 

Iliac,  Circumflex in 

External ni 

Internal no 

Ilio-lumbar ni 

Infra-orbital 207 

Innominate 103 

Intercostales 107, 108 

Lingual 104 

Lumbar no 

Mammary 107 

Maxillary,  Internal 105 

Meningeal,  Anterior 105 

Mesenteric,  Inferior no 

Superior 109 

of  Neubauer 103, 159 

Obturator 110,229 

Occipital 105 

Ophthalmic 105,206 

Palmar  arches 108 

Peroneal 113 

Pharyngeal,  Ascending 105 

Phrenic 109 

Plantar 113 

Popliteal 112 

Profunda  femoris 112 

inferior 108 

superior 107 

Pudic ni 

External 112 

Pulmonary 114 

Radial 108 

Renal no 

Sacral,  Lateral , in 

Middle no 

Sciatic ni 

Spermatic no 

Splenic 109,159 

Subclavian 106 

Sub-scapular 107 

Supra-renal no 

Supra-scapular 107 

Temporal 105 

Thoracic,  Acromial 107 

Superior 107 

Thoracica  alaris 107 

longa 107 

Thyroid 104, 159 

Inferior 107 

Thyroidea  ima 159 

Tibial,  Anterior 112 

Transversalis  colli 107 

Tympanic 105,218 

Ulnar 108 

Uterine 110 


PACK 

Artery,  Vaginal no 

Vertebral 106 

Vesical no 

Arthrodial  joints 55 

Articulation 55 

Atlo-axoid 57 

Carpal 62 

Carpo-metacarpal 62 

Costo-sternal 58 

Costo-transverse 58 

Costo-vertebral 58 

Metacarpo-metacarpal 63 

Metatarso-metatarsal 66 

Occipito-atloid 56 

Occipito-axoid 57 

Phalangeal  of  foot 66 

of  hand 63 

Radio-ulnar 59,  61 

Sacro-coccygeal 59 

Sacro-iliac 59 

Sacro-ischiatic 59 

Sacro-vertebral 59 

Scapulo-clavicular 60 

Sterno-clavicular 60 

Tarsal 53,65 

Tarso-metatarsal 66 

Temporo-maxillary 57 

Tibio-fibular 65 

Vertebral 56 

Arytenoid  cartilages 166 

Atlas 37 

Auricle 213 

Axis 37 

Coeliac 103,  109 

Optic 197 

Thyroid 107 

Visual 197 

Azygos n 

uvulae 74 

BAND,  DoUinger's 201 
Bartholine,  Duct  of. 145 

Glands  of. 188 

Bauhin,  Valve  of. 150,  151 

Bell,  Nerve  of 133 

Bellini,  Tubes  of 176 

Bertin,  Columns  of. 175 

Bladder 178 

Blastema 12 

Bodies,  Malpighian 176 

Pacchionian 121 

Body,  Ciliary aoo 

Hyaloid 205 

Olivary 128 

Perineal 232 

Pituitary 123 

Restiform 128 

Bone II 

Astragalus 53 

Clavicle 44 

Coccyx 41 

Cuboid 54 

Cuneiform 49»  54 

Ethmoid 21 

Femur 50 

Fibula 52 

Frontal " 


INDEX. 


279 


PAGB 

Bone,  Humerus 45 

Hyoid 53 

Ilium 42 

Incus 217 

Innominate 41 

Ischium 42 

Lachrymal 24 

Malar 24 

Malleus 217 

Maxillary,  Inferior 27 

Superior 22 

Nasal 22 

Occipital 14 

Os  calcis 53 

Os  magnum 49 

Palate 25 

Parietal 13 

Pectineal 43 

Peroneal 52 

Phalanges  of  foot 54 

of  hand 50 

Pisiform 49 

Pubic 43 

Sacral 40 

Scaphoid 49,  54 

Scapula 44 

Semilunar 49 

Sphenoid 18 

Stapes 217 

Sternum 38 

Temporal 15 

Tibia 51 

Trapezium 49 

Trapezoid 49 

Turbinated 19 

Inferior 26,  31 

Ulna 47 

Unciform 49 

Vomer 26 

Bones  of  the — 

Body 9 

Carpus 48 

Foot 53 

Hand 48 

Head 12 

Leg 51 

Lower  extremity 50 

Metacarpus 49 

Metatarsus 54 

Tarsus S3 

Trunk 36 

Upper  extremity 43 

Bones,  Unclassified lo 

Wormian 10,  33 

Bonnet,  Capsule  of 197 

Bowman's  membrane 199 

Muscle 200 

Bowman  and  Todd's  muscle 224 

B/ain 120 

Commissures  of  Brain 124 

Divisions 121 

Points  on  surface 123 

Ventricles 124 

Weights  of  average 121 

Bronchi 170,  171 

Brunner's  glands 151 

Bulb  of  corpus  cavernosum 183 


PAGB 

Bulb  of  corpus  spongiosum 182 

Bulbi  vestibuli 187 

Bulbs,  Olfactory 123 

Burns,  Ligament  of 228 

Bursae  of  knee-joint 65 

CJECVM 151 
Calamus  scriptorius 128 

Calices  of  the  kidney 175 

Canal,  Alimentary 141 

Auditory, External 214 

Internal 225 

Carotid 17 

Central  of  the  Cord 129 

Crural 228 

Dental 22,  28 

Femoral 228 

Hunter's 93 

Hyaloid 205 

Infraorbital 22,  29 

Inguinal 226 

of  the  modiolus 221 

Nutrient 52,  53 

Palatine 23 

Sacral 41 

Spiral  of  the  cochlea 221 

for  tensor  tympani 35 

Vidian 20,  35 

Canal  of— 

Cloquet 205 

Fontana 202 

Hugier 16,  35,  215 

Nuck 190 

Petit 204 

Schlemm 202 

Stilling 205 

Canaliculi 11.  212 

CanaHs  reuniens 223 

Canals,  Semicircular 221 

Membranous 223 

Canthus 210 

Capillaries 102 

Capsule  of  Bonnet , 197 

of  Glisson 150 

of  the  lens 204 

of  Miiller 176 

of  Tenon 197 

Capsules,  Supra-renal 160 

Caput  caecum  coli 151 

gallinaginis 179 

Carpus 49 

Cartilage 56 

Cartilages  of  the  larynx 165 

of  Santorini  ..  167 

Tarsal 210 

of  Wrisberg 167 

Cartilage  triticea 167 

Caruncuia  lachrymalis 211 

Carunculae  myrtiformes 187 

Cauda  equina 41,  129 

Cavity,  Cotyloid 41 

Glenoid  of  scapula 45 

of  the  omentum 163 

Orbital 29 

of  reserve 144 

Sigmoid 47 

of  the  radius 4S 


280 


PACB 

Celk,  Auditory 224 

Ethmoid 21 

Hepatic 156 

Mastoid 16,  216 

Olfactory  of  Schultze 196 

Cement 144 

Cerebellum 128 

Cerebrospinal  system 120 

Cerebrum 121 

its  convolutions 122 

its  lobes,  fissures,  etc 121 

Cervix  of  the  penis 182 

uteri 189 

Chopart's  operation 53 

Chordae  tendinae 100 

Choroid  tunic 200 

plexus 125 

Cilia 210 

Circle  of  Willis 106 

Circulus  arteriosus 201 

iridis  minor 202 

major  iridis 202 

venosus 192 

Clavicle 44 

Clinoid II 

Clitoris 187 

Cloquet,  Canal  of 205 

Fascia  of 228 

Coccyx 41 

Cochlea,  Membranous — 223 

Osseous 220 

Cceliac  Axis 103,  109 

Collar-bone 44 

Colon 152 

Flexures  of. 152 

Columnse  cameae loi 

papillares loi 

Columns  of  Bertin.... 175 

of  spinal  cord 129 

Commissure,  Optic... 123,  208 

Concha 213 

Condyles 10 

of  femur 51 

of  humerus 46 

Coni  vasculosi _ 184 

Conjunctiva 211 

Conus  arteriosus loi 

Convolutions  of  cerebrum 122 

Cooper,  Fascia  of. 229 

Coracoid ii 

Corium 194 

Cornea 199 

Cornicula  laryngis 167 

Comua  of  thyroid  cartilage 166 

uteri 189 

of  the  ventricles 125 

Corona  glandis 182 

radiata 127 

Coronoid 11 

Corpora  albicantia 123,  125 

cavernosa 182 

quadrigemina , 124,  127 

striata 123 

Corpus  Arantii loi 

tallosum 123,  125 

dentatum 128,  129 

fimbriatum xt5 


PAGB 

Corpus  Highmorianum 184 

luteum 191 

spongiosum 182 

Corpuscles,  Malpighian 158 

Tactile 194 

Corti,  Organ  of. 224 

Cortical  substance 175 

Cotunnius,  Liquor  of. 219 

Cotyloid II 

Coverings  of  the  testicle 184 

of  hernia 227,  229 

Cowper's  glands 181 

Crest  of  the  ilium 42 

lachrymal 30 

nasal 23 

of  the  pubes 43 

of  the  tibia 52 

turbinated 23,  25 

Cricoid  cartilage 166 

Crista  galli 21 

vestibuli 220 

Crura  cerebri 123,  127 

of  penis 182 

Crusta  petrosa 142 

Crypts  of  Lieberkiihn 151 

Cuneiform  cartilages 167 

Cuneus 122 

Cupola  of  cochlea 221 

Cuticle 193 

T^ARTOS 183 

*^     Dentine 142 

Derma 193 

Dermatology 9 

Descemet,  Membrane  of 199 

Diaphragm 83 

Diarthrosis 55 

Digestion,  Organs  of. 141 

Disc,  Optic 202 

Discus  proligerus 191 

DoUinger's  band 201 

Dorsum  of  scapula 44 

Douglas'  cul-de-sac 188 

Duct  of  Bartholine 145 

Cystic 157 

of  Gaertner 192 

Hepatic 155,  157 

Lymphatic 120 

of  Miiller 185 

Nasal 212 

Pancreatic 157 

of  Rivinus 145 

of  Steno 144 

Thoracic 119 

of  Wharton 144 

of  Wirsung 157 

Ducts,  Biliary 157 

Ejaculatory 186 

Seminal 180 

Ductus  cochlearis 223 

communis  choledochus 157 

Duodenum 150 

Dura  mater  of  cerebrum 120 

of  spinal  cord 129 

EAR - 212 
Internal aif 


INDEX. 


281 


PAGB 

Earstones 223 

Eminence,  Hypothenar 90 

Thenar ,. 90 

Eminentia  coUateralis 125 

Enamel 142 

Enarthrosis 55 

Endocardium 99 

Endolymph 220 

Endosteum 11 

Epidermis 193 

Epididymis  184 

Epigastric  region 162 

Epiglottis  167 

Epiphysis n 

Epiploa 164 

Equator  of  eye-ball 197 

Eustachian  tube 219 

Eye 197 

Its  appendages 209 

Eyeball 197 

Eyebrows 209 

Eyelashes 210 

Eyelids 209 


PACET 

■^      Fallopian  tubes 

Fallopius,  Aqueduct  of. 

Hiatus  of. 

Falx  cerebelli 

cerebri 

Fascia,  Anal 

Buck's 

of  Cloquet 

of  Cooper 

Cremasteric 

Cribriform 

Dentata 

Intercolumnar 

Ischio-rectal 

Lata 

Lumbar 

Obturator 

Palmar 

Perineal 230, 

Plantar 

Recto-vesical 

Tarso-orbital 

of  Testis 

Fasciae 

of  the  perineum 

Fasciculus  cuneatus 

gracilis 

Fauces 

Femur 

Fenestra  ovalis 216, 

rotunda 

Ferrein,  Pyramids  of 

Tubes  of. 

Fibro-cartilage 

Fibula 

Fimbriae 

Fimbriated  extremities 

Fissure,  Auricular 17 

Ethmoidal  

Glaserian ic,  qc. 

Palpebral f..... 


II 

190 
216 
35 
121 
120 
230 
230 
229 
229 
227 
228 
125 
226 
230 

?' 
82 

230 

90 

232 

97 

230 
211 
184 

67 
230 
128 
128 
144 

50 
220 

2X6 

176 
56 

52 

190 

190 
,35 

216 
209 


PAGE 

Fissure  Pterygo-maxillary 32 

of  Rolando 122 

Spheno-maxillary 30,  32 

Sphenoidal 20,  30,  34 

ofSylvius 122 

Transverse 125 

Fissures  of  cerebellum 128 

of  cerebrum 122 

of  liver 154 

of  spinal  cord, 129 

Folds,  Retro-tarsal 211 

Semi-lunar 211 

Fon tana.  Canal  of 202 

Spaces  of 201 

Fontanelles 33 

Foot 53 

Foramen  for  Arnold's  nerve 17,  35 

Caecum 12,  34 

Condyloid 35 

Ethmoidal 30,  34 

Incisive 23,35 

Infra-orbital 22,  35 

Inter-vertebral 36 

for  Jacobson's  nerve 17,  35 

Lacerum  anterius 20,  30,  34 

medium 35 

posterius 35 

Magnum 14. 35 

Mastoid 16,  35 

Mental 27,  35 

of  Munroe 124 

Nutrient 47,  48 

Obturator 42 

Olfactory 34 

Ovale 19,  34 

Optic 20,  30,  34 

Orbital 19 

Palatine 25,  35 

Petrosal 35 

Pterygo-palatine 35 

Rivinian 215 

Rotundum 19,  34 

Sacral 41 

of  Scarpa 23 

Spheno-palatine 25 

Spinal 36 

Spinosum 19,  34 

of  Stenson 23 

Stylo-mastoid 17,  35 

Supra-orbital 30,  35 

Supra-scapular 45 

Thyroid 4a 

Vesalii ,...19,  34 

of  Winslow 163 

Foramina  at  the  base  of  the  skull 34 

Olfactory 31 

Orbital 29 

Spheno-maxillary 32 

Thebesii 100 

Fore-arm 47 

Fornix 125 

Fossa,  Canine 22 

Coronoid 46 

Di-gastric 28 

Digital 50 

Glenoid 15 

Hyaloid 204,  205 


INDEX. 


PAGE 

Fossa,  Incisive 22,  27 

Infra-spinous 44 

Ischio-rectal 230 

Jugular 17 

Lachrymal 29 

Navicularis  of  vulva 188 

of  penis 180 

of  auricle 213 

Olecranon 46 

Ovalis 100 

Pterygoid 20 

Scaphoid 20 

Spheno-maxillary ,.  32 

Sublingual 28 

Sub-maxillary 28 

Subscapular 44 

Supraspinous 44 

Temporal 32 

Triangularis 213 

Zygomatic 32 

Fossae,  Nasal 31 

of  the  Skull 34,  35 

Fourchette 188 

Fovea  centralis 202 

hemispheric  a 220 

semi-elliptica 220 

Frenulum 127 

Frenum  preputii 183 

GiERTNER,  DHct  of, 192 
Gall-bladder 156 

Ganglia,  Basal 123 

Cervical 138 

of  Fifth  nerve 137 

of  the  Sympathetic 137 

Ganglion,  Arnold's 137 

Gasserian 131,  138 

Impar 137,  139 

Meckel's 137,  196 

of  Ribes 137 

Spheno-palatine 196 

Spirale 225 

Gasser,  Ganglion  of. 131,  138 

Genesiology  9 

Gimbernat's  ligament 227 

Ginglymus 55 

Gladiolus 38 

Gland,  Lachrymal 211 

Mammary 192 

Pineal 127 

Prostate 181 

Thymus 160 

Thyroid 159 

Stands  of  Bartholine 188 

Brunner's 151 

Cowper's 181 

Ductless 158 

Gastric I49 

Intestinal 152 

Lachrymal 211 

Littre's 180 

Lymphatic 119 

Meibomian 194,  210 

Sebaceous 194 

Solitary.... 151 

Sweat 195 

of  Tyson 183 


PAGB 

Glans  clitoridis 187 

penis 182 

Glenoid n 

Glisson's  capsule 156 

Globus  major 184, 185 

minor 185 

Glottis 168 

Gomphosis 55 

Graafian  vesicle 191 

Groove,  Bicipital 46 

Infraorbital .  ...23,  29 

Musculo-spiral 46 

Mylo-hyoid 28 

Naso-palatine 27 

Optic 18 

Pterygo-palatine 19 

Gubernaculum  testis 186 

Gums 141 

Gyrus,  Angular 122 

Fornicatus 122 

"LJAIRS 194 

^^     Hamstrings 94 

Hamular 11 

Hand 48 

Haversian  canals 11 

system 11 

Head  of  the  humerus 45 

of  the  ulna 47 

Heart 99,  loo 

Heel 53 

Helicotrema 331 

Helix 313 

Henle,  Tubes  of 176 

Hernia 326 

Femoral 228 

Inguinal 326 

Hey,  Ligament  of. 228 

Operation  of. 54 

Hiatus  Fallopii 16,  35 

Hihon,  Sac  of. 168 

Hilum  of  kidney 175 

Hippocampus  Major 125 

Minor 125 

Horner's  muscle 68 

Houston,  Folds  of ...  152 

Hugier,  Canal  of. 16,  35,  216 

Humerus 45 

Humor,  Aqueous 304 

Vitreous 205 

Humors  of  the  eyeball 198 

Hunter's  Canal 93 

Hydatids  of  Morgagni 185 

Hymen 187 

Hypochondrium 162 

Hypogastrium 163 

TLEUM 150 

•*■     Ilium 42 

Incisura  intertragica 213 

Infundibula  of  kidney 175 

Infundibulum. 13 

of  brain 123 

of  cochlea 321 

Inguinal  regions 163 

Intestine,  Large 151 

Small iS$ 


INDEX. 


283 


PAGE 

Intumescentia  gangliformis  Scarpse 225 

of  7th  nerve.... 138 

Iris 201 

Ischium 42 

Island  of  Reil 122 

Iter  chordae  anterius 216 

Iter  chordae  posterius 216 

Iter  e  tertio  ad  quartam  ventriculum 124 

Ivory 142 

JACOB'S  MEMBRANE 203 
Jacobson's  nerve 35,  132,  216,  218 

Jejunum 150 

Joint,  Ankle 65 

Elbow 61 

Hip 63 

Rotators  of  the  hip-joint 95 

Knee 63 

Shoulder 60 

Wrist 62 

Joints,  Motion  in 55 

Structures  of 55 


IDNEYS 17s 

Kirkring's  valves 151 


K 


T  ABIA  MAJORA 

•^-^     minora 

Labium  tympanicum 

vestibulare 

Labyrinth  219, 

Membranous 

Lacteals 

Lacuna  magna.., 

Lacunae 

Lacus  lachrymalis 

Lamina  cinerea 

cribrosa 

fusca 

reticularis 

spiralis 

Laminae 

Lancisi,  Nerves  of 

Larynx 

Layer,  Dermoid 

Ganglionic 

Granular 

Molecular 

Leg.-V 

Lens,  Crystalline 

Lieberkuhn,  Crypts  of. 

Ligament,  Annular 

Annular  of  foot 

of  Burns 

Canthal,  External 

Conoid 

Coronary 

Costo-xiphoid 

Cotyloid 

Crucial  of  knee-joint 

Cruciform 

Deltoid 

Falciform 

Gimbernat's 

Glenoid 

of  Hey 

Ilio-femoral  or  Y 

Q 


.64, 


187 
187 
224 
224 
220 
222 
119 
180 

II 
209 
123 
198 
198 
224 
221 

36 
125 
165 
215 
203 
203 
203 

51 
204 
151 

90 

97 
228 
210 

60 
154 

58 

64 
57 
65 
154 
227 
60 
228 
63 


PAGE 

Ligament,  Orbicular 61 

Poupart's 91,227 

Rhomboid 6j 

Round  of  the  liver 154 

cf  the  uterus 189 

Sacro-sciatic 59 

Stellate 58 

Stylo-mastoid 57 

Suspensory  of  lens 204 

of  liver 154 

of  penis 182 

of  spleen 158 

Transverse 57 

of  hip-joint 63 

Trapezoid »     6j 

Triancular 227 

of  perineum 230 

of  Zinn 205 

Ligaments 56 

of  the  Bladder 178 

Broad 189 

Canthal 210 

Check 57 

of  the  Knee-joint 64 

of  the  Larynx 167 

of  the  Liver 154 

of  the  Ossicles 217 

of  the  Ovaries 190 

Peritoneal 164 

of  the  Scapula 60 

of  the  Sternum 58 

Tarsal 210 

of  the  Uterus 189 

Ligamentum  latum  pulmonis 174 

mucosum ,     64 

nuchae 76 

patellae 64 

pectinatum  iridis 201 

spirale 224 

suspensorium 57 

teres 63 

Winslowii „.     64 

Ltmbus  laminae  spiralis 223 

Line,  Inter-trochanteric 50 

Popliteal 52 

Linea  aspera 51 

ilio-pectinea 42 

quadrati 50 

Liquor  Cotunnii 220 

Morgagni 204 

Scarpae 220 

Lithotomy,  Structures  affected 231 

Littre,  Glands  of. 180 

Liver 153 

Structure  of  liver 156 

Lobe  of  the  ear 213 

Lobes  of  the  cerebellum 128 

of  the  cerebrum  121 

of  the  liver « 154 

Optic 124,  127 

Lobule,  of  the  ear 213 

Paracentral  122 

Lobules  of  the  liver 156 

of  the  lung 173 

Lobulus  caudatus 155 

quadratus .°. 154 

Spigelii , 155 


284 


INDEX. 


PAGB 

Locus  niger 127 

Lower,  Tubercle  of. 100 

Lumbar  regions 163 

Lung,  Broad  ligament  of 174 

Lungs 171 

Lunula 194 

Lymphatics 119 

Hepatic 156 

of  Lung 173 

of  Penis 183 

of  Supra-renal  capsules i6i 

of  Thymus  gland 160 

of  Trachea  and  Bronchi 171 

of  Uterus 190 

Lymph-spaces  of  eyeball 207 

Lyra 125 

TUTACULA  ACOUSTICA 223 

*••■•     Macula  lutea 202 

Maculae  cribrosae 220 

Malleolar n 

Malleolus 52,  53 

Malpighi,  Bodies  of 176 

Pyramids  of. 176 

Malpighian  Corpuscles 158 

Tuft 176 

Mammae 192 

Manubrium 38 

of  the  malleus 217 

Marrow  of  bone 12 

Masses,  Lateral  of  Ethmoid 21 

Mastoid u 

Meatus  auditorius  externus 16 

internus 35 

nasi 31 

urinarius 183, 187 

Meckel's  ganglion 137 

Mediastinum 174 

testis 184 

Medulla  oblongata 127 

Medullary  substance 175 

Membrana  basilans 224 

granulosa 191 

Supillaris 202 
Luyschiana 200 

sacciformis 61,62 

tectoria 224 

tympani 214 

secundaria 216 

Membrane  of  Bowman 199 

of  Descemet 199 

Hyaloid 205 

Interosseous 61,65 

{acob's 203 
limiting 203 

Pituitary 195 

of  Reichert 199 

of  Reissner 223 

Schneiderian 195 

Shrapnell's 215 

Vitelline 191 

Membranes  of  Brain 120 

of  the  Spinal  Cord 129 

Synovial 56 

Tarsal  synovial 66 

Wrist  synovial 62 

Meridians  of  eyeball 197 


Mesenteries 164 

Meso-cephalon 127 

Mesos  j6.) 

Metacarpus 49 

Metatarsus 5^ 

Modiolus 221 

Mons  veneris 187 

Morgagni,  Hydatids  of. 183 

Sinus  of 168 

Mouth 144 

Miiiler,  Capsule  of. 176 

Duct  of. 185 

Muscle  of. 201 

Munroe,  Foramen  of. 124 

Muscle  of  Bowman 200 

Ciliary 200 

Cremaster 227 

Dilator  papillae 202 

Horner's 68 

Kerato-cricoideus 169 

Levator  glandulae  thyroideae 159 

of  Miilier 201 

Sphincter  papillae 202 

of  Todd  and  Bowman 224 

Triticeo-glossus 169 

Muscles 67 

of  the  abdomen 80-82 

of  the  arm 85 

of  the  auricle 213 

of  the  back 76-80 

Double-bellied 67 

of  the  ear 71 

of  the  epiglottis 75,  169 

of  the  eustachian  tube 219 

of  the  eyeball 68,  205 

of  the  face 69,  70 

of  the  forearm 87 

of  the  foot 98 

of  the  hand 90 

of  the  head 68 

of  the  hip 91 

of  the  larynx 75,  168 

of  the  leg 95 

of  the  neck 7i-75 

of  the  palate 74 

of  the  perineum 83,  231 

of  the  pharynx 73,  147 

of  the  shoulder 85 

of  the  stomach 149 

of  the  thigh 91 

of  the  thorax 82 

of  the  tympanum 218 

Muscular  fibre 67 

Musculi  pectinati 100 

Myology 9 

NABOTH,  Ovules  of 190 
Nails 194 

Nates  of  cerebrum 127 

Nasmyth's  membrane 142 

Neck  of  humerus 45,  46 

Neubauer,  Artery  of 103 

Nerve 120 

Abducens 131 

Arnold's  17,  35.  132 

Auditory 131,  225 

Bell's  respiratory 133 


INDEX. 


285 


PAGE 

Nerve,  Chorda  tympani 131,  195,  218 

Circumflex 134 

Cochlear 225 

Crural  anterior 135 

Facial 131 

Genito-crural 135 

Glosso-pharyngeal 132 

Hypo-glossal 132 

Ilio-hypogastric 135 

Ilio-inguinal 135 

Intercosto-humeral 134 

Interosseous 134 

ti;obson's 17,  35,  132,  215,  218 
ryngeal 170 

Maxillary,  Inferior 131 

Superior 131 

Median 133,  134 

Motor  oculi 130 

Musculo-spiral 134 

Nonus  or  9th  pair 132 

Obturator 135 

Olfactory 130 

Ophthalmic  div.  of  5th 131 

Optic 130,  209 

Parvagum 132 

Patheticus 130 

Phrenic 133 

Pneumogastric 132 

Portio  dura 131 

Portio  mollis 131 

Pudic 13S 

Radial 134 

Spinal  accessory 132 

Sympathetic 136 

Thoracic 134 

Trigeminus 130 

of  tongue  movements 195 

Tympanic 218 

Ulnar 134 

Vestibular 225 

Vidian 140 

of  Wrisberg 134 

Nerve-fibres,  Optic 203 

Nerves  of  ankle-joint 65 

of  auditory  canal 214 

of  auricle 214 

of  bladder 179 

of  choroid 200 

Cranial 129 

of  elbow-joint : 6i 

of  eustachian  tube 219 

of  eye 207 

of  eyelids.  210 

of  eye-muscles  206 

Hepatic 156 

of  hip-joint 63 

of  iris 202 

of  kidney 177 

of  knee-joint 63 

of  Lancisi 125 

oflarynx 7. 170 

of  lung 173 

of  membrana  tympani 216 

of  nasal  fossa 196 

of  nose 196 

of  oesophagus 148 

of  ovaries 191 


PAGE 

Nerves  of  pancreas 158 

of  penis 183 

Petrosal. ..- 131, 138, 140 

of  pharynx 147 

Popliteal 136 

Sciatic 136 

of  shoulder-joint 60 

Spinal 133 

Splanchnic 139 

of  spleen 159 

of  stomach 150 

of  supra-renal  capsules 161 

of  taste 195 

of  testicles 185 

of  thymus  gland 160 

Thyroid 160 

of  tongue 146 

of  trachea  and  bronchi 171 

of  tympanum 218 

of  uterus 190 

of  wrist-joint 02 

Nervous  system 12c 

Neurilemma 120 

Neurology 9 

Nipple 192 

Nose 19s 

Notch,  Cotyloid 42 

Inter-clavicular 38 

Inter-condyloid 51 

Pophteal 52 

Sacro-sciatic 42,  43 

Sigmoid 28 

Supra-orbital 30, 35 

Supra-scapular 45 

Nuck,  Canal  of. 190 

Nymphse 187 

QDONTOBLASTS 12,143 

^^     Odontoid 11 

CEsophagus 147 

Omentum 163,  164 

Opening,  Saphenous 91,  229 

Opercula 143 

Optic  thalami ....'. 123 

Ora  serrata 202 

Orbit 29 

Organ  of  Corti 224 

of  hearing 212 

of  Rosenmiiller 192 

of  sight 197 

ofsmell 19S 

Organs  of  generation 181,  187 

of  sense 193 

of  taste 195 

Urinary 175 

of  voice  and  respiration 165 

Os  orbiculare 217 

planum , 21 

tincae 189 

uteri 189 

Ossa  innominata 41 

triqueta 33 

Osteology 9 

Ossification 12 

Ossicles  of  tympanum 217 

Otoliths 223 

Ovaries 190 


ddd 


INDEX. 


PAGE 

Oviducts 190 

Ovisacs 191 

Ovules  of  Naboth 190 

Ovum 191 

PACCHIONIAN  BODIES 13 

■^      Palate 144 

Palpebrae 209 

Pampiniform  plexus 186 

Pancoast,  W.  H 49,  50,95,230 

Pancoast's  triangle  98 

Pancreas 157 

Lesser 158 

Papilla,  Lachrymal 209 

Oplic 202 

Papillae  of  skin. 194 

Parovarium 192 

Pars  ciliaris  retinae 203 

intermedia 187 

Peduncles  of  cerebellum 128 

Pelvis 40 

of  the  kidney 175 

Penis 182 

Pericardium 99 

Perilymph 220 

Perineum 230 

Female 232 

Periosteum  11 

Peritoneum 163, 165 

Peroneus 52 

Pes  accessorius 125 

hippocampi 125 

Petit,  Canal  of 204 

Peyer's  patches 151 

Phalanges 50 

Pharynx 146 

Pia  mater  of  brain 121 

of  spinal  cord 129 

of  the  testes 184 

Pinna 213 

Plane,  Equatorial 197 

Meridional 197 

Plantar  arch.'. 113 

Plate,  Cribriform 21 

Orbital 21 

Perpendicular 21 

Pleurae 174 

Plexus,  Brachial 133 

Carotid 139 

Cavernous 139 

Cervicnl 133 

Choroid 125 

Gastric 150 

Lumbar 135 

Lobular 155 

Pampiniform i?6,  191 

Sacral I35 

Solar 139 

Splenic 159 

Tympanic 218 

Plexuses  of  the  sympathetic 140 

Pli  courbe 122 

Plica  semilunaris 211 

Point,  Nodal 197 

Poles  of  the  eyeball 197 

Pomum  Adami 166 


PAGB 

Pons  Varolii 127 

Tarini 123 

Portal  system 118 

Porus  opticus 198 

Pouches  of  membrana  tympani 215 

Poupart's  ligament 227 

Precuneus 122 

Prepuce 183 

of  the  clitoris 187 

Process,  Acromion 44 

Alveolar 23 

Articular 36 

Auditory 16 

Basilar 14 

Clinoid 18 

Condyloid 28 

Coracoid 44 

Coronoid 28,  47 

Ethmoidal 26 

Falciform 228 

Hamular 20,  24 

of  cochlea 221 

Lachrymal 26 

Malar 23 

Mastoid 16 

Maxillary 26 

Mental.. 27 

Nasal 23 

Odontoid..... *  37 

Olecranon ..." 47 

Olivary 18 

Orbital 24,26 

Palate 23 

Pterygoid 20,  25 

Sphenoidal 26 

Spinous 36 

Styloid 17,  47,  48,  52 

Transverse 36 

Turbinated 21,  31 

Unciform 21 

Vaginal 17, 19 

Vermiform 128 

Zygomatic 15,  24 

Processes,  Ciliary 200 

Clinoid 20 

of  Ingrassias 20 

Processus  cochleariformis 17,217 

e  cerebeilo  ad  medullam 128 

ad  pontem 128 

ad  testes 127, 128 

gracilis 217 

zonulae 205 

Promontory  ol  tympanum 216 

Prostate  gland 181 

Prostatic  urethra 179 

sinus 180 

Pterygoid n 

Pubes 43 

Punctum  lachrymale 209 

Pupil 201 

Pylorus .-. 148,  149 

Pyramid,  Anterior 127 

Posterior 128 

of  tympanum 216 

Pyramids  of  Ferrein 176 

of  Malpighi 176 

of  Wistar 19 


287 


PAGE 

•pADIUS 48 

■■^     Rami  of  Inferior  Maxillary 28 

Ramus  of  ischium 43 

of  the  pubcs 43 

Receptaculum  ch>li 119 

Rectum »  152 

Regions  of  abdomen 162 

Reichert,  Membrane  of. 199 

Reil,  Island  of 122 

Reissner,  Membrane  of. 223 

Renal  vessels 176 

Rete  mucosum 193 

testis 184 

Retina 202,  204 

Ribes,  Ganglion  of. 137 

Ribs 38 

Ridge,  Mylo-hyoid 27 

Pterygoid 19 

Rima  glottidis 168 

Ring,  Abdominal 162,  226 

Crural 229 

Femoral 228 

Rings  and  phalanges 225 

Rivinus,  Duct  of. 145 

Segment  of 214 

Rods  and  cones 203 

of  Corti 224 

Rolando,  Fissure  of. 122 

Rosenmiiller,  Organ  of 192 

Rostrum II 

of  the  sphenoid 19 

OAC  OF  HILTON 168 

^     Lachrymal 212 

Saccule , 223 

Sacculus  laryngis 168 

Sacs  of  the  peritoneum 163 

Sacrum 40 

Santorini,  Cartilages  of. 167 

Sapolini 195 

Scala  media 222 

tympani 222 

vestibuli 222 

Scapula 44 

Scarpa,  Foramen  of. 23 

Intumentesciagang.  of. 225 

Liquor  of. 220 

Scheyer's  lines 142 

Schindylesis 55 

Schlemm,  Canal  of. 202 

Schultze,  Olfactory  cells  of. 196 

Schwann,  Substance  of. 120 

Sclerotic 198 

Scrotum 183 

Se.E;ment  of  Rivinus 214 

Sella  Turcica 18 

Septum  crurale 228 

lucidum 125 

nasi ji 

pectiniforme 182 

tubae 17,  216 

Sheath,  Crural 228,229 

Shin 52 

Shoulder 43 

Shoulder-blade 44 

Shrapnell's  membrane 215 

Sight,  Organ  of. 197 


PAGE 

Sigmoid  flexure  ,..    ,    152 

Silvius,  Aquedu  tof. 124 

Fissure  of. 122 

Sinus  aortici 102 

circularis  iridis 202 

of  the  kidney 175 

of  Morgagni 168 

pocularis 180 

Sinuses 115 

Sphenoidal 19 

of  Valsalva lox 

Skin 193 

Slit,  Nasal 31 

Smell,  Organ  of 195 

Space,  Inter-peduncular- 123 

Anterior  perforated 123 

Posterior  perforated 123 

Spaces,  Fontana's 201 

Spermatic  cord  186 

Sphincter  vesicae 179 

Spinal  cord 129 

Spine,  Ethmoidal 18 

of  the  ischium 43 

Nasal 23j25,  31 

of  .he  pubes 43 

of  the  scapula 44 

of  the  sphenoid 19 

of  the  tibia 51 

Spines  of  the  ilium 42 

Spina  tympanica 214 

Spinous II 

Splanchnology 9 

Spleen 158 

Spot,  BHnd 20a 

Germinal 191 

Light 215 

Yellow 202 

Squamous ii 

Stars  of  Verheyen 177 

Steno's  ducts 144 

Stenson's  foramen 23 

Sternum 38 

Stilling,  Canal  of. 205 

Styloid II 

Stomach 148 

Substance  of  Schwann 120 

Sulci 122 

Sulcus  spiralis  internus 224 

tympanicus 214 

Surface,  Auricular 4i)42 

Trochlear 46 

Sustentaculum  tali 53 

Sutura 55 

Suture,  Coronal 13 

Lachrymo-ethmo-frontal 30 

Lambdoidal 13 

Palato-maxillary 29 

Sagittal 13 

Spheno-malar 30 

Sutures,  Facial , 33 

of  the  orbit 30 

of  the  skull 33 

Sympathetic  system 120 

Symphysis 55 

of  inferior  maxillary 27 

Synarthrosis 55 

Synchondrosis 55 


288 


INDEX. 


PAGE 

Synovia 56 

Synovial  membranes 56 

Syndesmology 9 

nnAPETUM 201 

•*■      Tarsus 53 

Taste,  Nerves  of. 195 

Taste-buds 195 

Taenia  hippocampi 125 

semicircularis 125 

Teeth 141, 143 

Tendo  oculi 210 

Tendons 67 

Tenon,  Capsule  of. 197 

Tentorium  cerebelli 121 

Testes 183 

of  the  cerebrum 127 

Descent  of. 186 

Thebesius,  Foramina  of. 100 

Thigh 50 

Thorax 38 

Thyroid  axis 107 

cartilage 166 

Todd  and  Bowman's  muscle 224 

Tongue 145,  195 

Tonsils 144 

Torcular  Herophili 14 

Trachea 170 

Tract,  Lateral 128 

Optic 208 

Uveal 200 

Tracts,  Olfactory 123 

Tractus  spiralis  forminosus 225 

Tragus 213 

Triangle,  Fancoast's 98 

Trigonjim  vesicae 178 

Trochanters 10 

of  femur 50 

Trochlear 11 

Tube,  Eustachian 17,  35,216,  219 

Tuber  annulare 124 

cinereum 123 

Tubercle 10 

Genial 27 

of  Lower 100 

Tubero-sities 10 

of  femur 51 

of  humerus 45 

of  ischium 43 

Maxillary 23 

Tubes  of  Bellini 176 

of  Ferrein 176 

of  Henle 176 

Tubuli  galactopheri 192 

lactiferi 192 

seminiferi 184 

uriniferi 176 

Tuft,  Malpighian 176 

Tunica  albuginea 184 

vaginalis 184 

oculi 197 

vasculosa 184,200 

Tunics  of  eyeball 198 

Tutamina  oculi 209 

Tympanum 216 

Tyson,  Glands  of. 183 


PAGH 

TJLNA 4, 

^^      UmbiHcal  region 163 

Umbilicus 162 

Umbo 215 

Urachus 178 

Uretfers 177 

Urethra 179 

Bulb  of. 180 

Uterus 188 

masculinus 180 

Utricle 222 

Uvea 201 

Uvula 144 

vesicae 179 

TTAGINA 188 

^      Vaginal 11 

Vallecula  cerebelli 128 

Valsalva,  Sinuses  of. loi,  102 

Valve  of  Bauhin 150, 151 

Eustachian 100 

Ileo-csecal 150, 151 

Mitral lor 

Tricuspid 100 

of  Vieussens 127 

Valves  of  Kirkring 151 

Semilunar loi,  102 

Valvulae  conniventes 151 

Vas  deferens 185 

Vasa  efferentia 184 

recta 184 

vasorum 102 

Vasculum  aberrans 185 

Vein,  Axillary 116 

Basilic 116 

Cephalic 116 

Femoral 118 

Median 116 

PopHteal 118 

Portal 118,  15s 

Radial 116 

Splenic 159 

Sub-clavian 117 

Supra-renal 161 

U]«ar 116 

Vena  Cava 117, 118 

Vertebral 116 

Veins 115,202 

Azygos 116 

ofbone 12 

Cardiac 119 

Choroid 200 

of  the  eye 207 

of  head  and  neck 115 

Hepatic 155 

Iliac... 118 

Innominate 117 

Jugular no 

of  the  kidney 177 

of  the  larynx 170 

Lobular 155 

of  lower  extremities 117 

of  the  lung J73 

of  oesophagus 148 

of  the  pancreas 158 

Pulmonary 119 

of  the  penis 183 


INDEX. 


289 


Veins,  Saphenous ii8    1 

Spinal ii6    j 

of  the  stomach 150 

of  supra-renal  capsules 161    ' 

•f  the  thorax 116 

of  thymus  gland 160 

Thyroid 160 

of  trachea  and  bronchi 171 

Uterine 190 

without  valves 115    '. 

Velum  interpositum 125    j 

Venae  comites 115    j 

proprise  renales 177    ! 

rectae 177 

vorticosae 200    j 

Venter  of  the  ilium 42    I 

of  the  scapula 44 

Ventricle  of  the  cord 129 

Fifth 126 

Fourth 126 

of  the  larynx 168 

Third 126 

Ventricles,  Lateral 124 

Verheyen,  Stars  of. 177 

Vertebra  prominens 37 

Vertebrae 36 

Veru  montanum 179 

Vesalius,  Foramen  of. 35 

Vesical,  Germinal 191 

Graafian 191 

Vesiculae  seminales 186 

Vestibule 187 

of  the  ear 220 

Vidian  canal 20 

n*rv« 140 


PACK 

Vieussens,  Valve  of. 127 

ViUi 151 

Viscera 141 

covered  by  peritoneum 165 

Vitellus 191 

Vocal  chords 168 

Vomer 26 

Vortex  of  the  heart ir2 

Vulva 187 

Orifice  of 232 

TX7ALLS  OF  THE  TYMPANUM...  216 

VV      Wharton's  ducts 144 

Willis,  Circle  of 106 

Wings  of  the  sphenoid 19 

Winsiow,  Foramen  of. 163 

Ligament  of 64 

Wirsung,  Duct  of. 157 

Wistar,  Pyramids  of 19 

Wormian  bones 10 

Wrisberg,  Cartilages  of. 167 

Nerve  of. 134 

Y^LK 191 

^-INN,  LIGAMENT  OF 205 

^         Zone  of 199 

Zonula  of. 204 

Zona  pellucida 191 

Zone,  Peripheral 199 

of  Zinn 199 

Vascular 199 

Zonula  of  Zinn j»4 

Zygoma ij 


A  Classified  Catalogue  of 
Books  on  Medicine  and  the 
Collateral  Sciences,  Phar- 
macy, Dentistry,  Chemistry, 
Hygiene,    Microscopy,    Etc. 


^ 


P.  Blakiston's  Son  &  Company,  Pub- 
lishers of  Medical  and  Scientific  Books, 
IOI2    Walnut    Street,    Philadelphia 


No,  8.     1-18-02. 


SUBJECT   INDEX. 


Special  Catalogues  of  Books  on  Pharmacy,  Dentistry, 
Chemistry,  Hygiene,  and  Nursing  will  be  sent  free  upon 
application.  All  inquiries  regarding  prices,  dates  of  edition, 
terms,  etc.,  will  receive  prompt  attention. 


SUBJECT.  PAGE 

Alimentary  Canal  (see  Surgeiy)  19 

Anatomy 3 

Anesthetics 14 

Autopsies  (see  Pathology) 16 

Bacteriology  (see  Pathology)..  16 

Bandaging  (see  Surgery) 19 

Blood,  Examination  of 16 

Brain  4 

Chemistry.     Physics 4 

Children,  Diseases  of 6 

Climatology ,  14 

Clinical  Charts 20 

Compends 22,  23 

Consumption  (see  Lungs) 11 

Cyclopedia  of  Medicine 8 

Dentistry 7 

Diabetes  (see  Urin.  Organs)..  21 

Diagnosis 6 

Diagrams  (see  Anatomy) 3 

Dictionaries,  Cyclopedias 8 

Diet  and  Food 14 

Dissectors 3 

Ear 9 

Electricity 9 

Embryology 3 

Emergencies 19 

Eye 9 

Fevers 9 

Food 14 

Gynecology 21 

Hay  Fever 20 

Heart 10 

Histology 10 

Hydrotherapy 14 

Hygiene 11 

Hypnotism 14 

Insanity  4 

Intestines  (see  Miscellaneous)  14 
Latin,  Medical  (see  Miscella- 
neous and  Pharmacy) 14, 16 

Life  Insurance 14 

Lungs II 

Massage 12 

Materia  Medica 12 

Mechanotherapy 12 

Medical  Jurisprudence 13 


SUBJECT.  PAGB 

Mental  Therapeutics 4 

Microscopy  13 

Milk  Analysis  (see  Chemistry)      4 

Miscellaneous  14 

Nervous  Diseases  14 

Nose 20 

Nursing 15 

Obstetrics 16 

Ophthalmology 9 

Organotherapy 14 

Osteology  (see  Anatomy) 3 

Pathology 16 

Pharmacy 16 

Physical  Diagnosis 6 

Physical  Training 12 

Physiology  17 

Pneumotherapy 14 

Poisons  (see  Toxicology) 13 

Practice  of  Medicine 18 

Prescription  Books 18 

Refraction  (see  Eye) 9 

Rest 14 

Sanitary  Science 11 

Skin 19 

Spectacles  (see  Eye) 9 

Spine  (see  Nervous  Diseases)  14 
Stomach  (see  Miscellaneous)...  14 

Students'  Compends 22,  23 

Surgery    and     Surgical    Dis- 
eases   19 

Technological  Books 4 

Temperature  Charts 6 

Therapeutics 12 

Throat  20 

Toxicology 13 

Tumors  (see  Surgery) 19 

U.  S.  Pharmacopoeia 17 

Urinary  Organs 20 

Urine 20 

Venereal  Diseases... 21 

Veterinary  Medicine 21 

Visiting  Lists,  Physicians'. 
{Send for  Special  Circular^ 

Water  Analysis 11 

Women,  Diseases  of. ai 


Self-Examination  for  Medical  Students.  3500  Questions  on 
Medical  Subjects,  with  References  to  Standard  Works  in  which  the 
correct  replies  will  be  found.  Together  with  Questions  from  State 
Examining  Boards.     3d  Edition.     Paper  Cover,  10  cts. 


SUBJECT  CATALOGUE  OF  MEDICAL  BOOKS.  3 

SPMCIAI,  NOTM' — The  prices  given  in  this  catalogue  are 
net,  no  discount  can  be  allowed  retail  purchasers  under  any  considera- 
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meet  previous  retail  discounts.  Upon  receipt  of  the  advertised  price  any 
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ANATOMY. 

MORRIS.  Text-Book  ot  Anatomy.  2d  Edition.  Revised  and 
Enlarged.  790  Illustrations,  214  of  which  are  printed  in  colors. 
Thumb  Index  in  Each  Copy.  Cloth,  $6.00 ;  Leather,  I7.00 

"  The  ever-growing  popularity  of  the  book  with  teachers  and  students 

is  an  index  of  its  value." — Medical  Record,  Neiu  York. 

BROOMELL.  Anatomy  and  Histology  of  the  Human  Mouth 
and  Teeth.    284  Illustrations.  $450 

CAMPBELL.  Dissection  Outlines.  Based  on  Morris' Anatomy, 
2d  Edition.  .50 

DEAVER.     Surgical  Anatomy.     A  Treatise  on  Anatomy  in  its 
Application  to  Medicine  and  Surgery.   With  400  very  Handsome  full- 
page  Illustrations  Engraved  from  Original  Drawings  made  by  special 
Artists  from  dissections  prepared  for  the  purpose.     Three  Volumes. 
Cloth,  $21.00;  Half  Morocco  or  Sheep,  $24.00;  Half  Russia,  $27.00 

GORDINIER.  Anatomy  of  the  Central  Nervous  System. 
With  271  Illustrations,  many  of  which  are  original.  Cloth,  $6.00 

HEATH.    Practical  Anatomy.    8th  Edition.    300  lUus.  $4.25 

HOLDEN.  Anatomy.  A  Manual  of  Dissections.  Revised  by  A. 
Hbwson,  M.D.,  Demonstrator  of  Anatomy,  Jefferson  Medical  College, 
Philadelphia.  320  handsome  Illustrations.  7th  Edition.  In  two 
compact  i2mo  Volumes.  850  Pages.  Large  New  Type.  Just  Ready. 
Vol,  I.  Scalp— Face— Orbit— Neck— Throat— Thorax— Upper  Ex- 
tremity. $1.50 
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Ear — Mammary  Gland — Scrotum — Testes.  $1.50 

HOLDEN.  Human  Osteology.  Comprising  a  Description  of  the 
Bones,  with  Colored  Delineations  of  the  Attachments  of  the  Muscles. 
The  General  and  Microscopical  Structure  of  Bone  and  its  Develop- 
ment.  With  Lithographic  Plates  and  numerous  Illus.   8th  Ed.    $5.25 

HOLDEN.     Landmarks.    Medical  and  Surgical.    4th  Ed.  .75 

HUGHES  AND  KEITH.  Dissections.  With  Colored  and  other 
Illustrations.    In  three  i*arts :  I,  Upper  and  Lower  Extremity, 

Ready.     $3.00 
II,  Abdomen,  Pelvis  ;  III,  Perineum,  Thorax.  In  Press. 

MACALISTER.  Human  Anatomy.  Systematic  and  Topograph- 
ical.    816  Illustrations.  Cloth,  $5.00;  Leather,  $6.00 

McMURRICH.     Embryology.     Illustrated.  In  Press. 

MARSHALL.  Physiological  Diagrams.  Life  Size.  Colored. 
Eleven  Life-Size  Diagrams  (each  seven  feet  by  three  feet  seven 
inches).     Designed  for  Demonstration  before  the  Class, 

In  Sheets,  Unmounted,  $40.00 ;  Backed  with  Muslin  and  Mounted 
on  Rollers,  $60.00 ;  Ditto,  Spring  Rollers,  in  Handsome  Walnut  Wall 
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Explanatory  Key,  .50.     Purchaser  must  pay  freight  charges. 

POTTER.  Compend  of  Anatomy,  Including  Visceral  Anatomy. 
6th  Ed.    16  Lith.  Plates  and  117  other  Illus.     .80 ;  Interleaved,  $1.00 

V^ILSON.    Anatomy,    nth  Edition,    429  Illus,,  26  Plates.      $5,00 

W^INDLE.    Surface  Anatomy.    Colored  and  other  Dlus.       $i,oo 


SUBJECT  CATALOGUE. 


BRAIN  AND  INSANITY  (see  also 
Nervous  Diseases). 

BLACKBURN.  A  Manual  of  Autopsies.  Designed  for  the  Use 
of  Hospitals  for  the  Insane  and  other  Public  Institutions.  Ten  fiill- 
page  Plates  and  other  Illustrations.  ^1.25 

DERCUM.     Mental  Therapeutics,  Rest,  etc.        Nearly  Ready. 

GORDINIER.  The  Gross  and  Minute  Anatomy  of  the  Central 
Nervous  System.     With  full-page  and  other  Illustrations.      $6.00 

HORSLEY.  The  Brain  and  Spinal  Cord.  The  Structure  and 
Functions  of.     Numerous  Illustrations.  ^2.50 

IRELAND.    The  Mental  Affections  of  Children.    2d  Ed.    ^4.00 

LEWIS  (BEVAN).  Mental  Diseases.  A  Text-Book  Having 
Special  Reference  to  the  Pathological  Aspects  of  Insanity.  26  Litho- 
graphic Plates  and  other  Illustrations.     2d  Ed.  $700 

MANN.  Manual  of  Psychological  Medicine  and  Allied 
Nervous  Diseases.  $3.00 

PERSHING.  Diagnosis  of  Nervous  and  Mental  Disease. 
Illustrated.    Just  Ready.  |i-25 

REGIS.  Mental  Medicine.  Authorized  Translation  by  H.  M. 
Bannister,  m.d.  $2.00 

SHUTTLEWORTH.     Mentally  Deficient  Children.  J1.50 

STEARNS.  Mental  Diseases.  With  a  Digest  of  Laws  Relating 
to  Care  of  Insane.    Illustrated.  Cloth,  J2.75 ;  Sheep,  $3.25 

TUKE.  Dictionary  of  Psychological  Medicine.  Giving  the 
Definition,  Etymology,  and  Symptoms  of  the  Terms  used  in  Medical 
Psychology,  with  the  Symptoms,  Pathology,  and  Treatment  of  the 
Recognized  Forms  of  Mental  Disorders.    Two  volumes.  f  10.00 

WOOD,  H.  C.    Brain  and  Overwork.  .40 


CHEMISTRY  AND  TECHNOLOGY. 

special  Catalogue  of  Chemical  Books  sent  free  upon  application. 

ALLEN.    Commercial   Organic   Analysis.    A  Treatise  on  the 

Modes  of  Assaying  the  Various  Organic  Chemicals  and  Products 

Employed  in  the  Arts,  Manufactures,  Medicine,  etc.,  with  concise 

methods  for  the  Detection  of  Impurities,  Adulterations,  etc.     8vo. 

Vol.  I.  Alcohols,  Neutral  Alcoholic  Derivatives,  etc.,  Ethers,  Veg- 
etable Acids,  Starch,  Sugars,  etc.     3d  Edition.  |^4.5o 

Vol.  II,  Part  I.  Fixed  Oils  and  Fats,  Glycerol,  Explosives,  etc. 
3d  Edition.  $3  50 

Vol.  II,  Part  II.  Hydrocarbons,  Mineral  Oils,  Lubricants,  Benzenes, 
Naphthalenes  and  Derivatives,  Creosote,  Phenols,  etc.  3d  Ed.  ^3,50 

Vol.  II,  Part  III.  Terpenes,  Essential  Oils,  Resins,  Camphors,  etc. 
3d  Edition.  Preparing. 

Vol.  Ill,  Part  I.  Tannins,  Dyes  and  Coloring  Matters.  3d  Edition. 
Enlarged  and  Rewritten.     Illustrated.  If  4-5° 

Vol.  Ill,  Part  II.  The  Amines,  Hydrazines  and  Derivatives, 
Pyridine  Bases.  The  Antipyretics,  etc.  Vegetable  Alkaloids,  Tea, 
Coffee,  Cocoa,  etc.     8vo.     2d  Edition.  $450 

Vol.  Ill,  Part  III.  Vegetable  Alkaloids,  Non-Basic  Vegetable  Bitter 
Principles.  Animal  Bases,  Animal  Acids,  Cyanogen  Compounds, 
etc.    2d  Edition,  8vo.  ^54-5° 

Vol.  IV.    The  Proteids  and  Albuminous  Principles.    2d  Ed.      $4.50 


MEDICAL  BOOKS. 


BAILEY  AND  CADY.    Chemical  Analysis.    Just  Ready,  ^i.-is 
BARTLEY.    Medical    and    Pharmaceutical    Chemistry.     A 

Text-Book  for  Medical,  Dental,  and  Pharmaceutical  Students.   With 
Illustrations,  Glossary,  and  Complete  Index.    5th  Edition.         I3.00 

BARTLEY.  Clinical  Chemistry.  The  Examination  of  Feces, 
Saliva,  Gastric  Juice,  Milk,  and  Urine.  $1.00 

BLOXAM.  Chemistry,  Inorganic  and  Organic.  With  Experi- 
ments.   9th  Ed.,  Revised.     281  Engravings.  Preparing. 

CALDWELL.  Elements  of  Qualitative  and  Quantitative 
Chemical  Analysis.    3d  Edition,  Revised.  ^i.oc 

CAMERON.     Oils  and  Varnishes.    With  Illustrations.  J2.25 

CAMERON.     Soap  and  Candles.    54  Illustrations.  ^2.00 

CLOWES  AND  COLEMAN.  Quantitative  Analysis.  5th 
Edition.     122  Illustrations.  JS-So 

COBLENTZ.  Volumetric  Analysis.  Illustrated  Just  Ready.  $1.25 

CONGDON.  Laboratory  Instructions  in  Chemistry.  With 
Numerous  Tables  and  56  Illustrations.  ^i.oo 

GARDNER.  The  Brewer,  Distiller,  and  Wine  Manufac- 
turer.    Illustrated.  |i.5o 

GRAY.  Physics.  Volume  I.  Dynamics  and  Properties  of  Matter. 
350  Illustrations.    Just  Ready.  $4-50 

GROVES  AND  THORP.    Chemical  Technology.    The  Appli- 
cation  of  Chemistry  to  the  Arts  and  Manufactures. 
Vol.  I.  Fuel  and  Its  Applications.     607  Illustrations  and  4  Plates. 

Cloth,  I5.00;  y^  Mor.,  J6.50 
Vol.  II.    Lighting.      Illustrated,  Cloth,  $4.00;  >^  Mor.,  $5.50 

Vol.  III.  Gas  Lighting.  Cloth,  ^3.50 ;  %  Mor.,  $4.50 

Vol.  IV.  Electric  Lighting.     Photometry.  In  Press. 

HEUSLER.     TheTerpenes.  In  Press. 

HOLLAND.  The  Urine,  the  Gastric  Contents,  the  Common 
Poisons,  and  the  Milk.  Memoranda,  Chemical  and  Microscopi- 
cal, for  Laboratory  Use.     6th  Ed.     Illustrated  and  interleaved,  $1.00 

LEFFMANN.  Compend  of  Medical  Chemistry,  Inorganic 
and  Organic.     4th  Edition,  Revised.  .80;  Interleaved,  |i  .00 

LEFFMANN.      Analysis  of   Milk   and   Milk    Products.     2d 
Edition,  Enlarged.     Illustrated.  ^1-25 

LEFFMANN.  W^ater  Analysis.  For  Sanitary  and  Technic  Pur- 
poses.    Illustrated.    4th  Edition.  ^1.25 

LEFFMANN.  Structural  Formulae.  Including  180  Structural 
and  Stereo-Chemical  Formulae.     i2mo.     Interleaved.  $i.bo 

LEFFMANN  AND  BEAM.  Select  Methods  in  Food  Analy- 
sis.    Illustrated  ^2  50 

MUTER.  Practical  and  Analytical  Chemistry.  2d  American 
from  the  Eighth  English  Edition.  Revised  to  meet  the  requirements 
of  American  Students.     56  Illustrations.  I1.25 

OETTEL.     Exercises  in  Electro-Chemistry.    Illustrated.        .75 

OETTEL.     Electro-Chemical  Experiments.    Illustrated.         .75 

RICHTER.  Inorganic  Chemistry.  5th  American  from  loth  Ger- 
man Edition.  Authorized  translation  by  Edgar  F.  Smith,  m.a., 
PH.D.     89  Illustrations  and  a  Colored  Plate.  ^1.75 

RICHTER.  Organic  Chemistry.  3d  American  Edition.  Trans, 
from  the  8th  German  by  Edgar  F.  Smith.  Illustrated.  2  Volumes. 
Vol.    I.    Aliphatic  Series.     625  Pages.  $3.00 

Vol.  II.    Carbocyclic  Series.    671  Pages.  .  $3.00 


SUBJECT  CATALOGUE, 


ROCKWOOD.     Chemical  Analysis  for  Students  of  Medicine, 

Dentistry,  and  Pharmacy.    Illustrated.    Just  Ready.  $1.50 

SMITH.    Electro-Chemical  Analysis.    2d  Ed.    28  Illus.       ^1.25 

SMITH  AND  KELLER.    Experiments.    Arranged  for  Students 

in  General  Chemistry.     4th  Edition.     Illustrated  .60 

SUTTON.    Volumetric  Analysis.     A  Systematic  Handbook  for 

the  Quantitative  Estimation  of  Chemical  Substances  by   Measure, 

Applied  to  Liquids,  Solids,  and  Gases.      8th  Edition,  Revised.     112 

Illustrations.  $5.00 

SYMONDS.    Manual  of  Chemistry.    2d  Edition.  $2.00 

TRAUBE.    Physico-Chemical  Methods.    Translated  by  Hardin. 

97  Illustrations.  $1.50 

THRESH.    "Water  and  Water  Supplies.    3d  Edition.  $2.00 

ULZER  AND  FRAENKEL.    Chemical  Technical  Analysis. 

Translated  by  Fleck.     Illustrated.  $1-25 

WOODY.    Essentials    of    Chemistry    and    Urinalysis.     4th 

Edition.    Illustrated.  $1.50 

*♦*  Special  Catalogue  of  Books  on  Chemistry  free  upon  application. 


CHILDREN. 

CAUTLEY.    Feeding  of  Infants  and  Young  Children  by  Nat- 
ural and  Artificial  Methods.  $2.00 
HALE.    On  the  Management  of  Children.  .50 

HATFIELD.  Compend  of  Diseases  of  Children.  With  a 
Colored  Plate.    2d  Edition.  .80;   Interleaved,  $1.00 

IRELAND.  The  Mental  Affections  of  Children.  Idiocy, 
Imbecility,  Insanity,  etc.     2d  Edition.  $4.00 

POWER.  Surgical  Diseases  of  Children  and  their  Treat- 
ment by  Modern  Methods.    Illustrated.  I2.50 

SHUTTLEWORTH.  Mentally  Deficient  Children.  New 
Edition.  $1.50 

STARR.  The  Digestive  Organs  in  Childhood.  The  Diseases  of 
the  Digestive  Organs  in  Infancy  and  Childhood.  3d  Edition,  Rewrit- 
ten and  Enlarged.     Illustrated.    Just  Ready.  J3.C0 

STARR.  Hygiene  of  the  Nursery.  Including  the  General  Regi- 
men and  Feeding  of  Infants  and  Children,  and  the  Domestic  Manage- 
ment of  the  Ordinary  Emergencies  of  Early  Life,  Massage,  etc.  6th 
Edition.     25  Illustrations.  ^i.oo 

SMITH.    "Wasting  Diseases  of  Children.    6th  Edition.        ^2.00 

TAYLOR  AND  WELLS.  The  Diseases  of  Children.  2d  Edi- 
tion, Revised  and  Enlarged.     Illustrated.     Svo.  I4.50 

DIAGNOSIS. 

BROW^N.     Medical  Diagnosis.     A  Manual  of  Clinical  Methods. 

4th  Edition.     112  Illustrations.  Cloth,  ^2.25 

DA  COSTA.     Clinical  Examination  of  the  Blood.    Illustrated. 

In  Press. 
EMERY.     Bacteriological  Diagnosis.  In  Press. 

MEMMINGER.   Diagnosis  by  the  Urine.  2d  Ed.  24  Illus.  |i.oo 


MEDICAL   BOOKS. 


PERSHING.    Diagnosis  of  Nervous  and   Mental   Diseases. 

Illustrated.    Just  Ready.  $i-25 

STEELL.     Physical  Signs  of  Pulmonary  Disease.  $1.25 

TYSON.  Hand-Book  of  Physical  Diagnosis.  For  Students  and 
Physicians.  By  the  Professor  of  Chnical  Medicine  in  the  University 
of  Pennsylvania.  Illus.  4th  Ed.,  Improved  and  Enlarged.  With 
Two  Colored  and  55  other  Illustrations.    Just  Ready.  |>i.5o 


DENTISTRY. 

special  Catalogue  of  Dental  Books  sent  free  upon  application. 

BARRETT.  Dental  Surgery  for  General  Practitioners  and 
Students  of  Medicine  and  Dentistry.  Extraction  of  Teeth, 
etc.     3d  Edition.     Illustrated.  Jgi.oo 

BROOMELL.  Anatomy  and  Histology  of  the  Human  Mouth 
and  Teeth.     284  Handsome  Illustrations.  $4-5o 

FILLEBROWN.     A    Text-Book    of    Operative    Dentistry. 

Written  by  invitation  of  the  National  Association  of  Dental  Facul- 
ties.    Illustrated.  ^2.25 

GORGAS.  Dental  Medicine.  A  Manual  of  Materia  Medica  and 
Therapeutics.    7th  Edition.    Just  Ready.   Cloth,  $4.00;  Sheep,  1^5.00 

GORGAS.  Questions  and  Answers  for  the  Dental  Student. 
Embracing  all  the  subjects  in  the  Curriculum  of  the  Dental  Student. 
Octavo.    Just  Ready.  |6.oo 

HARRIS.  Principles  and  Practice  of  Dentistry.  Including 
Anatomy,  Physiology,  Pathology,  Therapeutics,  Dental  Surgery, 
and  Mechanism.  13th  Edition.  Revised  by  F.  J.  S.  Gorgas,  m.d., 
D.D.s.     1250  Illustrations.  Cloth,  J|6.oo;  Leather,  I7.00 

HARRIS.  Dictionary  of  Dentistry.  Including  Definitions  of  Such 
Words  and  Phrases  of  the  Collateral  Sciences  as  Pertain  to  the  Art  and 
Practice  of  Dentistry.  6th  Edition.  Revised  and  Enlarged  by  Fer- 
dinand F.  S.  Gorgas,  m.d.,  d.d.s.         Cloth,  ^5.00 ;  Leather,  |6.oo 

HEATH.  Injuries  and  Diseases  of  the  Jaws.  4th  Edition.  187 
Illustrations.  I4.50 

RICHARDSON.    Mechanical   Dentistry.     7th   Edition.     Thor- 
oughly Revised  and  Enlarged  by  Dr.  Geo.  W.  Warren.     691  Illus- 
trations. Cloth,  ^5.00;  Leather,  |6.oo 
SMITH.     Dental  Metallurgy.    Illustrated.  $1.75 
TAFT.    Index  of  Dental  Periodical  Literature.                   ^2.00 

TOMES.     Dental  Anatomy.    Human  and  Comparative.    263  Illus- 
trations.    5th  Edition.  I4.00 
TOMES.    Dental  Surgery.    4th  Edition.    289  Illustrations.     J4.00 

WARREN.  Compend  of  Dental  Pathology  and  Dental  Medi- 
cine.    With  a  Chapter  on  Emergencies.     3d  Edition.     Illustrated. 

.80;  Interleaved,  $1.25 
WARREN.  Dental  Prosthesis  and  Metallurgy.  129  Ills,  fi.25 
WHITE.    The  Mouth  and  Teeth.     Illustrated.  .40 


SUBJECT  CATALOGUE. 


DICTIONARIES  AND  CYCLOPEDIAS 

QOULD.    The  Illustrated  Dictionary  ol  Medicine,  Biology 
and  Allied  Sciences.     Being  an  Exhaustive  Lexicon  of  Medicine 
and  those  Sciences  Collateral  to  it:    Biology  (Zoology  and  Botany), 
Chemistry.  Dentistry,  Parmacology,  Microscopy,  etc.,  with  many 
usefiil  Tables  and  numerous  fine  Illustrations.     1633  pages.     5th  Ed. 
Sheep  or  Half  Dark  Green  Leather,  |io.oo;  Thumb  Index,  $11.00 
Half  Russia,  Thumb  Index,  $12.00 
QOULD.    The  Medical  Student's  Dictionary,     nth  Edition. 
Illustrated.     Including  all  the  Words  and  Phrases  Generally  Used 
inMedicine,  with  their  Proper  Pronunciation  and  Definition,  Based 
on  Recent  Medical  Literature.    With  Table  of  Eponymic  Terms  and 
Tests  and  Tables  of  the  Bacilli,  Micrococci,  Mineral  Springs,  etc., 
of  the  Arteries,  Muscles,  Nerves,  Ganglia,  Plexuses,  etc.     nth  Edi- 
tion.    Enlarged  and  illustrated  with  a  large  number  of  Engravings. 
840  pages.  Half  Green  Morocco,  $2.^0 ;  Thumb  Index,  $3  00 

QOULD.  The  Pocket  Pronouncing  Medical  Lexicon.  4th  Edi- 
tion. (30,000  Medical  Words  Pronounced  and  Defined.)  Containing 
all  the  Words,  their  Definition  and  Pronunciation,  that  the  Medical, 
Dental,  or  Pharmaceutical  Student  Generally  Comes  in  Contact 
With ;  also  Elaborate  Tables  of  Eponymic  Terms.  Arteries,  Muscles, 
Nerves,  Bacilli,  etc.,  etc.,  a  Dose  List  in  both  English  and  Metric 
Systems,  etc.,  Arranged  in  a  Most  Convenient  Form  for  Reference  and 
Memorizing.  Fourth  Edition,  Revised  and  Enlarged.  838 
pages.  Full  Limp  Leather,  Gilt  Edges,  $i.oo  ;  Thumb  Index,  $1.25 
130,000  Copies  of  Gould's  Dictionaries  Have  Been  Sold. 
GOULD  AND  PYLE.  Cyclopedia  of  Practical  Medicine  and 
Surgery.  Seventy-two  Special  Contributors.  Illustrated. 
One  Volume.  A  Concise  Reference  Handbook,  Alphabetically 
Arranged,  of  Medicine,  Surgery,  Obstetrics,  Materia  Medica, 
Therapeutics,  and  the  Various  Specialties,  with  Particular  Reference 
to  Diagnosis  and  Treatment.  Compiled  under  the  Editorial  Super- 
vision of  George  M.  Gould,  m.d..  Author  of  "An  Illustrated 
Dictionary  of  Medicine  "  :  Editor  "  Philadelphia  Medical  Journal," 
etc.;  and  Walter  L.  Pyle,  m.d..  Assistant  Surgeon  Wills  Eye 
Hospital  ;  formerly  Editor  "  International  Medical  Magazine,"  etc., 
and  Seventy-two  Special  Contributors.  With  many  Illustrations. 
Large  Square  Svo,  to  correspond  with  Gould's  "  Illustrated  Dic- 
tionary." Full  Sheep  or  Half  Dark-Green  Leather, $io.co 
With  Thumb  Index,  $11.00;  Half  Russia,  Thumb  Index.  $12,00  net. 
GOULD  AND  PYLE.  Pocket  Cyclopedia  of  Medicine  and 
Surgery.  Ba.sed  upon  above  book  and  uniform  in  size  with  "  Gould's 
Pocket  Dictionary." 

Full  Limp  Leather,  Gilt  Edges,  $1.00,  with  Thumb  Index,  $1.25 
HARRIS.  Dictionary  of  Dentistry.  Including  Definitions  ol  Sucn 
Words  and  Phrases  of  the  Collateral  Sciences  as  Pertain  to  the  Art 
and  Practice  of  Dentistry.     6th  Edition.     Revised  and  Enlarged  by 
Ferdinand  J.  S.  Gorgas,  m.d.,  d.d.s.   Cloth,  $5.00;  Leather,  $6  00 
LONGLEY.     Pocket  Medical  Dictionary.    With  an  Appendix, 
containing  Poisons  and  their  Antidotes,  Abbreviations  usee!  in  Pre- 
scriptions, etc.  Cloth,  .75  ;  Tucks  and  Pocket,  $1.00 
MAXWELL,      Terminologia   Medica    Polyglotta.       By  Dr, 
Theodore  Maxwell,  Assisted  by  Others.  $3.00 
The  object  of  this  work  is  to  assist  the  medical  men  ot  any  nationality 
In  reading   medical  literature  written  in  a  language  not  their  own. 
Eath  term  is  usually  given  in  seven  languages,  viz, :  English,  French, 
German,  Italian,  Spanish,  Russian,  and  Latin, 

TREVES  AND  LANG,    German-English  Medical  Dictionary. 

Half  Russia,  $3.35 


MEDICAL  BOOKS. 


EAR  (see  also  Throat  and  Nose). 

BURNETT.     Hearing  and  How  to  Keep  It.    Illustrated.  .40 

DALBY.      Diseases  and  Injuries  of  the  Ear.    4th  Edition.     38 

Wood  Engravings  and  8  Colored  Plates.  ^2.50 

HOVELL.  Diseases  ot  the  Ear  and  Naso-Pharjrnx.  Includ- 
ing Anatomy  and  Physiology  of  the  Organ,  together  with  the  Treat- 
ment of  the  Affections  of  the  Nose  and  Pharynx  which  Conduce  to 
Aural  Disease.     128  Illustrations.     2d  Edition.    Just  Ready.      $5.50 

PRITCHARD.  Diseases  of  the  Ear.  3d  Edition,  Enlarged. 
Many  Illustrations  and  Formulae.  jJi.So 

ELECTRICITY. 

BIGELO^V.  Plain  Talks  on  Medical  Electricity  and  Bat- 
teries. With  a  Therapeutic  Index  and  a  Glossary.  43  Illustra- 
tions.    2d  Edition.  ^i.oo 

HEDLEY.  Therapeutic  Electricity  and  Practical  Muscle 
Testing.    99  Illustrations.  $2.50 

JACOBY.   Electrotherapy.  2  Vols.   Illustrated.   Including  Special 

Articles  by  Various  Authors.     (Subscription.)     Tust  Ready.       $5.00 

JONES.   Medical  Electricity.  3d  Edition.  117  lUus.  $3.00 

EYE. 

A  Special  Circular  of  Books  on  the  Eye  sent  free  upon  application. 

DONDERS.  The  Nature  and  Consequences  of  Anomalies  of 
Refraction.     With  Portrait  and  Illustrations.     Half  Morocco,  Ji. 25 

PICK.  Diseases  of  the  Eye  and  Ophthalmoscopy.  Trans- 
lated by  A.  B.  Halk,  m.  d.  157  Illustrations,  many  of  which  are  in 
colors,  and  a  glossary.  Cloth,  I4.50 ;  Sheep,  J5.50 

GOULD  AND  PYLE.  Compend  of  Diseases  of  the  Eye  and 
Refraction.  Including  Treatment  and  Operations,  and  a  Section 
on  Local  Therapeutics.  With  Formulae,  Useful  Tables,  a  Glossary, 
and  III  Illus.,  several  of  which  are  in  colors.     2d  Edition,  Revised. 

Cloth,  .80;  Interleaved,  Ji.oo 

GREEFF.  The  Microscopic  Examination  of  the  Eye.  Illus- 
trated.   Just  Ready.  $1-25 

HARLAN.    Eyesight,  and  How  to  Care  for  It.    Illus.  ,40 

HARTRIDGE.  Refraction.  104  Illustrations  and  Test  Types, 
nth  Edition,  Enlarged.  #1.50 

HARTRIDGE.  On  the  Ophthalmoscope.  4th  Edition.  With 
4  Colored  Plates  and  68  Wood-cuts.  jSi-So 

HANSELL  AND  REBER.  Muscular  Anomalies  of  the  Eye. 
Illustrated.  $1.50 

HANSELL  AND  BELL.  Clinical  Ophthalmology.  Colored 
Plate  of  Normal  Fundus  and  120  Illustrations.  |i.So 

JENNINGS.  Manual  of  Ophthalmoscopy,  95  Illustrations  and 
I  Colored  Plate.    Just  Ready,  •  $150 


10  SUBJECT  CATALOGUE. 

MORTON.    Refraction  of  the  Eye.    Its  Diagnosis  and  the  Cor- 
rection of  it%  Errors,     6th  Edition.  J1.00 

OHLEMANN.     Ocular  Therapeutics.    Authorized  Translation, 
and  Edited  by  Dr.  Charles  A.  Oliver.  |i-75 

PARSONS.     Elementary  Ophthalmic  Optics.     With  Diagram- 
matic Illustrations.    Just  Ready.  ;^2.oo 

PHILLIPS.     Spectacles  and  Eyeglasses.     Their  Prescription 
and  Adjustment.    2d  Edition.     49  Illustrations.  ^i.oo 

SWANZY.     Diseases  of  the  Eye  and  Their  Treatment.    7th 

Edition,  Revised  and  Enlarged.     164   Illustrations,  i  Plain  Plate, 
and  a  Zephyr  Test  Card.  J2.50 

From  The  Medical  News. 

"  Swanzy  has  succeeded  in  producing  the  most  intellectually  con- 
ceived and  thoroughly  executed  resume  of  the  science  within  the 
limits  he  has  assigned  himself.  As  a  'students'  handbook,'  small 
in  size  and  of  moderate  price,  it  can  hardly  be  equaled." 

THORINGTON.    Retinoscopy.    4th  Edition.    Carefully  Revised. 
Illustrated.  $1.00 

THORINGTON.    Refraction  and  How  to  Refract.    200  lUustra- 
tions,  13  of  which  are  Colored.     2d  Edition.  J1.50 

WALKER.     Students'  Aid  in  Ophthalmology.     Colored  Plate 
and  40  other  Illustrations  and  Glossary.  t^-So 

WRIGHT.    Ophthalmology.     2d  Edition,  Revised  and  Enlarged. 
117  Illustrations  and  a  Glossary.  $3.00 


FEVERS. 

GOODALL  AND  WASHBOURN.    Fevers  and  Their  Treat- 
ment.    Illustrated.  ^3.00 

HEART. 

THORNE.    The  Schott  Methods  of  the  Treatment  of  Chronic 
Heart  Disease.    Third  Edition.    Illustrated.  ^1.75 


HISTOLOGY. 

CUSHING.  Compend  of  Histology.  By  H.  H.  Cushing,  m.d.. 
Demonstrator  of  Histology,  Jefferson  Medical  College,  Philadelphia. 
Illustrated.    Nearly  Ready.  .80;  Interleaved,  Ji.co 

STIRLING.  Outlines  of  Practical  Histology.  368  Illustrations. 
2d  Edition,  Revised  and  Enlarged.    With  new  Illustrations.       $2.00 

STOHR.  Histology  and  Microscopical  Anatomy.  Edited  by 
A.  Schaphr,  M.D.,  University  of  Breslau,  formerly  Demonstrator  of 
Histology,  Harvard  Medical  School.  Fourth  American  from  9th  Ger- 
man Edition,.Revised  and  Enlarged.    379  lUus.   Just  Ready,    fo.oo 


MEDICAL  BOOKS. 


HYGIENE  AND  WATER  ANALYSIS. 

special  Catalogue  of  Books  on  Hygiene  sent  free  upon  application. 

CANPIELD.  Hygiene  of  the  Sick-Room.  A  Book  for  Nurses 
and  Others.  Being  a  Brief  Consideration  of  Asepsis,  Antisepsis,  Dis- 
infection, Bacteriology,  Immunity,  Heating,  Ventilation,  etc.      $1.25 

CONN.     Agricultural  Bacteriology.     IIlus.   Just  Ready.      JI2.50 

COPLIN.  Practical  Hygiene.  A  Complete  American  Text-Book. 
138  Illustrations.     New  Edition.  Preparing . 

HARTSHORNE.    Our  Homes.     Illustrated.  .40 

KENWOOD.  Public  Health  Laboratory  Work.  116  Illustra- 
tions and  3  Plates.  $2.00 

LEFFMANN.  Select  Methods  in  Food  Analysis.  53  Illustra- 
tions and  4  Plates.  $2.50 

LEFFMANN.  Examination  ot  Water  for  Sanitary  and 
Technical  Purposes.     4th  Edition.    Illustrated.  $1.25 

LEFFMANN.  Analysis  of  Milk  and  Milk  Products.  Illus- 
trated.   Second  Edition.  ^1.25 

LINCOLN.    School  and  Industrial  Hygiene.  .40 

McFARLAND.    Prophylaxis  and  Personal  Hygiene.  In  Press. 

NOTTER.  The  Theory  and  Practice  of  Hygiene.  15  Plates 
and  138  other  Illustrations.     8vo.    2d  Edition.  ^7.00 

PARKES.  Hygiene  and  Public  Health.  By  Louis  C.  Parkes, 
M.D.     6th  Edition.     Enlarged.    Illustrated.  ^3.00 

PARKES.  Popular  Hygiene.  The  Elements  of  Health.  A  Book 
for  Lay  Readers.     Illustrated.  $^-^S 

STARR.  The  Hygiene  of  the  Nursery.  Including  the  General 
Regimen  and  Feeding  of  Infants  and  Children,  and  the  Domestic 
Management  of  the  Ordinary  Emergencies  of  Early  Life,  Massage, 
etc.    6th  Edition.    25  Illustrations.  Ji.oo 

STEVENSON  AND  MURPHY.  A  Treatise  on  Hygiene.  By 
Various  Authors.     In    Three    Octave   Volumes.    Illustrated. 

Vol.  I,  $6.00;  Vol.  II,  I6.00;  Vol.  Ill,  >s.oo 
*#*  Each  Volume  sold  separately.  Special  Circular  upon  application. 

THRESH.    Water  and  Water  Supplies.    3d  Edition.  ^2.00 

WILSON.  Hand-Book  of  Hygiene  and  Sanitary  Science. 
Wiih  Illustrations.     8th  Edition.  $3-oo 

WEYL.  Sanitary  Relations  of  the  Coal-Tar  Colors.  Author- 
ized Translation  by  Henry  Lbffmann,  m.d.,  ph.d.  $^-^5 


LUNGS  AND  PLEURA. 

KNOPF.     Pulmonary  Tuberculosis.     Its  Modem  Prophylaxis 
and  Treatment  in  Special  Institutions  and  at  Home.     lUus.        J3.00 

STEELL.     Physical  Signs  of  Pulmonary  Disease.   Illus.  $1.25 


12  SUBJECT  CATALOGUE. 

MASSAGE— PHYSICAL  EXERCISE. 

OSTROM.  Massage  and  the  Original  Swedish  Move- 
ments. Their  Application  to  Various  Diseases  of  the  Body.  A 
Manual  for  Students,  Nurses,  and  Physicians.  Fourth  Edition,  En- 
larged.    105  Illustrations,  many  of  which  are  original.  ^i.oo 

MITCHELL  AND  GULICK.  Mechanotherapy.  lUus.  In  Press. 
TREVES.     Physical  Education.     Methods,  etc.  .75 

WARD.     Notes  on  Massage.     Interleaved.  Paper  cover, ^i. 00 


MATERIA    MEDICA    AND     THERA- 
PEUTICS. 

BIDDLE.  Materia  Medica  and  Therapeutics.  Including  Dose 
List,  Dietary  for  the  Sick,  Table  of  Parasites,  and  Memoranda  ot 
New  Remedies.  13th  Edition,  Revised.  64  Illustrations  and  a 
Clinical  Index.  Cloth,  $4.00;  Sheep,  ^5.00 

BRACKEN.    Outlines  of  Materia  Medica  and  Pharmacology.    $2.75 

COBLENTZ.  The  Newer  Remedies.  Including  their  Synonyms, 
Sources,  Methods  of  Preparation,  Tests,  Solubilities,  Doses,  etc. 
3d  Edition,  Enlarged  and  Revised.  |i.oo 

COHEN.  Physiologic  Therapeutics.  Mechanotherapy,  Mental 
Therapeutics,  Electrotherapy.  Climatology,  Hydrotherapy,  Pneu- 
matotherapy.  Prophylaxis,  Dietetics,  etc.  11  Volumes,  Octavo. 
Illustrated.     {Subscription.)  Cloth,  $27.50  ;  J^  mor.,  138.50 

Special  Descriptive  Circular  will  be  sent  upon  application. 
DAVIS.    Materia  Medica  and  Prescription  Writing.        I1.50 

GORQAS.  Dental  Medicine.  A  Manual  of  Materia  Medica  and 
Therapeutics.     7th  Edition,  Revised.     Just  Ready.  f  4.00 

GROFF.  Materia  Medica  for  Nurses,  with  questions  for  Self  Exam- 
ination and  a  complete  Glossary.  $1.25 

HELLER.  Essentials  of  Materia  Medica,  Pharmacy,  and 
Prescription  Writing.  $1.50 

MAYS.    Theine  in  the  Treatment  of  Neuralgia.    %  bound,  .50 

POTTER.  Hand-Book  of  Materia  Medica,  Pharmacy,  and 
Therapeutics,  including  the  Action  of  Medicines,  Special  Therapeu- 
tics, Pharmacology,  etc.,  including  over  600  Prescriptions  and  For- 
mula. 8th  Edition,  Revised  and  Enlarged.  With  Thumb  Index  in 
each  copy.  Cloth,  $5.00;  Sheep,  $6.00 

POTTER.  Compend  of  Materia  Medica,  Therapeutics,  and 
Prescription  Writing,  with  Special  Reference  to  the  Physiologi- 
cal Action  of  Drugs.    6th  Edition.  .80;  Interleaved,  $1.00 

MURRAY.     Rough  Notes  on  Remedies.    4th  Edition.         $1.25 


MEDICAL  BOOKS.  18 

SAYRE.    Organic  Materia  Medica  and  Pharmacognosy.    An 

Introduction  to  the  Study  of  the  Vegetable  Kingdom  and  the  Vege- 
table and  Animal  Drugs.  Comprising  the  Botanical  and  Physical 
Characteristics.  Source,  Constituents,  and  Pharmacopeial  Prepara- 
tions, Insects  Injurious  to  Drugs,  and  Pharmacal  Botany.  With 
sections  on  Histology  and  Microtechnique,  by  W.  C.  Stevens. 
374  Illustrations,  many  of  which  are  original.    2d  Edition. 

Cloth,  $4.50 

FA  VERA.     Medicinal  Plants  of  the  Philippines.    Just  Ready. 

WHITE  AND  WILCOX.    Materia  Medica,  Pharmacy,  Phar- 

macology,  and  Therapeutics.  5th  American  Edition,  Revised  by 
Reynold  W.  Wilcox,  m.a.,  m.d.,  ll.d..  Professor  of  Clinical 
Medicine  and  Therapeutics  at  the  New  York  Post-Graduate  Medical 
School.    Just  Ready.  Cloth,  ^3.00;  Leather,  ^.50 

"  The  care  with  which  Dr.  Wilcox  has  performed  his  work  is  con- 
spicuous on  every  page,  and  it  is  evident  that  no  recent  drug  possess- 
ing any  merit  has  escaped  his  eye.  We  believe,  on  the  whole,  this  is 
the  best  book  on  Materia  Medica  and  Therapeutics  to  place  in  the 
hands  of  students,  and  the  practitioner  will  find  it  a  most  satisfactory 
work  for  daily  use." —  The  Cleveland  Medical  Gazette. 


MEDICAL    JURISPRUDENCE     AND 
TOXICOLOGY. 


REESE.   Medical  Jurisprudence  and  Toxicology.  A  Text-Book 

for  Medical  and   Legal   Practitioners  and  Students.     5th   Edition. 
Revised  by  Henry  Leffmann,  m.d.       Clo.,|3.oo;  Leather,  ^3.50 


"  To  the  student  of  medical  jurisprudence  and  toxicology  it  is  in- 
valuable, as  it  is  concise,  clear,  and  thorough  in  every  respect." — TTu 
American  Journal  of  the  Medical  Sciences. 

MANN.     Forensic  Medicine  and  Toxicology.    Illus.  ^.50 

TANNER.    Memoranda  of  Poisons.    Their  Antidotes  and  Tests. 
8th  Edition,  by  Dr.  Henry  Leffmann.  .75 


MICROSCOPY. 

CARPENTER.     The  Microscope  and    Its   Revelations.    8th 

Edition,  Revised  and  Enlarged.      817  Illustrations  and  23   Plates. 
Just  Ready.  Cloth,  |8.oo ;  Half  Morocco,  ^.00 

LEE.  The  Microtomist's  Vade  Mecum.  A  Hand-Book  of 
Methods  of  Microscopical  Anatomy.  .887  Articles,  sth  Edition, 
Enlarged.  ^4.00 

REEVES.  Medical  Microscopy,  including  Chapters  on  Bacteri- 
ology, Neoplasms,  Urinary  Examination,  etc.  Numerous  Illus- 
trations, some  of  which  are  printed  in  colors.  ^a-So 

WETHERED.  Medical  Microscopy.  A  Guide  to  the  Use  of  the 
Microscope  in  Practical  Medicine.    100  Illustrations.  $2.00 


14  SUBJECT  CATALOGUE. 

MISCELLANEOUS. 

BERRY.     Diseases  of  Thyroid  Gland.     Illustrated.  «4.oo 

BURNETT.     Foods  and  Dietaries.    A  Manual  of  Clinical  Diet- 
etics.    2d  Edition.  <i  cq 
BUXTON.    Anesthetics.    Illustrated.    3d  Edition.                   Sico 
COHEN.     Organotherapy.                                                      In  Press. 
DAVIS.     Dietotherapy.     Food  in  Health  and  Disease.     (Sub- 
scription.)   Just  Ready.                                                                     $2.50 
GOULD.      Borderland    Studies.      Miscellaneous  Addresses  aiid 
Essays.     i2mo.                                                                                       I2.00 
GREENE.     Medical  Examination  for  Life  Insurance.     Illus- 
trated.                                                                                                  J4.00 
HAIG.    Causation  of  Disease  by  Uric  Acid.    The  Pathology  of 
High  Arterial  Tension,  Headache,  Epilepsy,  Gout,    Rheumatism, 
Diabetes,  Bright's  Disease,  etc.     sthEdition.                                 $300 
HAIG.    Diet  and  Food.    Considered  in  Relation  to  Strength  and 
Power  of  Endurance.     3d  Edition.                                                    ;$i.oo 
HEMMETER.     Diseases  of  the  Stomach.    Their  Special  Path- 
ology, Diagnosis,  and  Treatment.     With  Sections  on  Anatomy,  Diet- 
etics, Surgery,  etc.    2d  Edition,  Revised  and  Enlarged.     Illustrated. 

Cloth,  $6.00;  Sheep,  $7.00 
HEMMETER.  Diseases  of  the  Intestines.  Illustrated.  2  Vol- 
umes. 8vo.  Just  Ready.  Cloth,  |io  00;  Sheep,  $12.00 
HENRY.  A  Practical  Treatise  on  Anemia.  Hall  Cloth,  .50 
LEFFMANN.  Food  Analysis.  Illustrated.  ^2.50 
NEW  SYDENHAM  SOCIETY'S  PUBLICATIONS.  Circulars 
upon  application.  Per  Annum,  48. 00 
OSGOOD.  The  Winter  and  Its  Dangers.  .40 
OSLER  AND  McCRAE.  Cancer  of  the  Stomach.  $2.00 
PACKARD.  Sea  Air  and  Sea  Bathing.  .40 
RICHARDSON.  Long  Life  and  How  to  Reach  It.  .40 
ST.  CLAIR.  Medical  Latin.  $i.oo 
TISSIER.  Pneumatotherapy.  /« Press. 
TURNBULL.  Artificial  Anesthesia.  4th  Edition.  Illus.  $2.50 
WEBER  AND  HINSDALE.  Climatology.  2  Vols.  Illustrated 
with  Maps.  Just  Ready,  {iiubscription.)  $5.00 
WILSON.  The  Summer  and  Its  Diseases.  .40 
WINTERNITZ.     Hydrotherapy.     Illustrated.                  In  Press. 


NERVOUS  DISEASES. 

DERCUM.    Rest,  Hypnotism,  Mental  Therapeutics.    In  Press. 

GORDINIER.  The  Gross  and  Minute  Anatomy  of  the  Cen- 
tral Nervous  System.  With  271  original  Colored  and  other 
Illustrations.  Cloth,  J6.00;  Sheep,  J7.00 

GOWERS.  Manual  of  Diseases  of  the  Nervous  System.  A 
Complete  Text-Book.  Revised,  Enlarged,  and  in  many  parts  Re- 
written. With  many  new  Illustrations.  Two  volumes. 
Vol.  I.  Diseases  of  the  Nerves  and  Spinal  Cord.  3d  Edition,  En- 
larged. Cloth,  J4.00;  Sheep,  J5.00 
Vol.  II.  Diseases  of  the  Brain  and  Cranial  Nerves;  General  and 
Functional  Disease.     2d  Edition.              Cloth,  J4.00;  Sheep,  Js.oo 

GOWERS.    Syphilis  and  the  Nervous  System.  ^i.oo 


MEDICAL  BOOKS.  15 


GOWERS.  Epilepsy  and  Other  Chronic  Convulsive  Diseases. 

2d  Edition.    Just  Ready.  ^3.00 

HORSLEY.    The   Brain  and  Spinal  Cord.    The  Structure  and 
Functions  of.     Numerous  Illustrations.  ^2.50 

ORMEROD.     Diseases  of  the  Nervous  System.    66  Wood  En- 
gravings. |i.oo 

PERSHING.     Diagnosis  of  Nervous  and  Mental  Diseases. 

Illustrated.    Just  Ready.  $1.25 

PRESTON.    Hysteria  and  Certain  Allied  Conditions.    Their 
Nature  and  Treatment.    Illustrated.  ^2.00 

WOOD.    Brain  Work  and  Overwork.  .40 


NURSING  (see  also  Massage). 

special  Catalogue  of  Books  for  Nurses  sent  free  upon  application. 

CANFIELD.  Hygiene  of  the  Sick-Room.  A  Book  for  Nurses  and 
Others.  Being  a  Briet  Consideration  of  Asepsis,  Antisepsis,  Disinfec- 
tion, Bacteriology,  Immunity,  Heating  and  Ventilation,  and  Kindred 
Subjects  for  the  Use  of  Nurses  and  Other  Intelligent  Women.    J1.25 

CUFF.    Lectures  to  Nurses  on  Medicine.    Third  Edition.    %t..^s 

DOMVILLE.    Manual  for  Nurses  and  Others  Engaged  in  At- 
tending the  Sick.   9th  Edition.  With  Recipes  for  Sick-room  Cook- 
ery, etc.  In  Press. 
FULLERTON.     Obstetric  Nursing.    41  Ills,    sth  Ed.  |i.oo 
FULLERTON.     Surgical    Nursing.    3d  Ed.    69  Ills.          |i.oo 

GROFF.  Materia  Medica  for  Nurses.  With  Questions  for  Self-Ex- 
amination  and  a  very  complete  Glossary.  $1.25 

"  It  will  undoubtedly  prove  a  valuable  aid  to  the  nurse  in  securing  a 

knowledge  of   drugs  and  their  uses.'' — The  Medical  Record,  New 

York. 

HADLEY.     Medical  and  Surgical  Nursing.       Nearly  Ready. 

HUMPHREY.     A    Manual    for     Nurses.      Including    General 

Anatomy  and   Physiology,  Management  of  the  Sick  Room,    etc 

23d  Edition.    79  Illustrations.  ^i.oo 

"  In  the  fullest  sense.  Dr.  Humphrey's  book  is  a  distinct  advance  on 

all  previous   manuals.    It  is,  in  point  of  fact,  a  concise  treatise  on 

medicine  and  surgery  for  the  beginner,  incorporating  with  the  text  the 

management  of  childbed  and  the  hygiene  of  the  sick-room.     Its  value 

is  greatly  enhanced  by  copious  wood -cuts  and  diagrams  of  the  bones 

and  internal  organs." — British  Medical  Journal ,  London. 

STARR.  The  Hygiene  of  the  Nursery.  Including  the  General 
Regimen  and  Feeding  of  Infants  and  Children,  and  the  Domestic  Man- 
agement of  the  Ordinary  Emergencies  of  Early  Life,  Massage,  etc.  6th 
Edition.    25  Illustrations.  |i.oo 

TEMPERATURE  AND  CLINICAL  CHARTS.    See  page  6. 

VOSWINKEL.  Surgical  Nursing.  Second  Edition,  Enlarged. 
112  Illustrations.  $1.00 


16  SUBJECT  CATALOGUE. 

OBSTETRICS. 

CAZEAUX  AND  TARNIER.  Midwifery.  With  Appendix  by 
Mund6.  The  Theory  and  Practice  of  Obstetrics,  including  the  Dis- 
eases ot  Pregnancy  and  Parturition,  Obstetrical  Operations,  etc. 
8th  Edition.  Illustrated  by  Colored  and  other  full-page  Plates,  and 
numerous  Wood  Engravings.  Cloth,  $4.50  ;  Full  Leather,  $5.50 

EDGAR.     Text-Book  of  Obstetrics.     Illustrated.       Preparing. 

FULLERTON.    Obstetric  Nursing.     5th  Ed.    Illustrated.    |i.oo 

LANDIS.  Compend  of  Obstetrics.  7th  Edition,  Revised  by  Wm. 
H.  Wells,  Demonstrator  of  Clinical  Obstetrics,  Jefferson  Medical 
College.     52  Illustrations.  .80;  Interleaved,  $1.00 

WINCKEL.  Text-Bookof  Obstetrics,  Including  the  Pathol- 
ogy and  Therapeutics  of  the  Puerperal  State.  Authorized 
Translation  by  J.  Clifton  Edgar,  m.d.     Illus.  Cloth,  fc.oo 

PATHOLOGY. 

BARLOW.    General  Pathology.     795  pages,    Svo.  fo.oo 

BLACK.     Micro-Organisms.     The  Formation  of  Poisons.  .75 

BLACKBURN.  Autopsies.  A  Manual  of  Autopsies  Designed  for 
the  Use  ot  Hospitals  for  the  Insane  and  other  Public  Institutions. 
Ten  full-page  Plates  and  other  Illustrations.  $1-25 

CONN.     Agricultural  Bacteriology.     Illus.    Just  Ready.      $2.50 
COPLIN.  Manual  of  Pathology.  Including  Bacteriology,  Technic 
of  Post-Mortems,  Methods  of  Pathologic  Research,  etc.     330  Illus- 
trations, 7  Colored  Plates.     3d  Edition.  ^3>50 
DA  COSTA.    Clinical  Hematology.     Six  Colored  Plates  and  48 
Illustrations.     Just  Ready.                                                                    $5.00 
EMERY.    Bacteriological  Diagnosis.                               In  Press. 
HEWLETT.     Manual  of  Bacteriology.   75  Illustrations.    Second 
Edition,  Revised  and  Enlarged.                                                     In  Press. 
ROBERTS.   Gynecological  Pathology.   Illus.  Just  Ready    ^6.00 
THAYER.       Compend    of    General    Pathology.       Illustrated. 
Nearly  Ready.     .80;  Interleaved,  Ji.co 
THAYER.     Compend  of  Special  Pathology.     Illustrated. 

Nearly  Ready.     .80;  Interleaved,  |i. 00 
VIRCHOW.    Post-Mortem  Examinations.    3d  Edition.         .75 
WHITACRE.     Laboratory  Text-Book  of   Pathology.     With 
121  Illustrations.  #i-5o 

WILLIAMS.  Bacteriology.  A  Manual  for  Students.  90  Illus- 
trations.   2d  Edition,  Revised.  |i-5o 

PHARMACY. 

special  Catalogue  of  Books  on  Pharmacy  sent  free  upon  application. 

COBLENTZ.  Manual  of  Pharmacy.  A  Complete  Text-Book 
by  the  Professor  in  the  New  York  College  of  Pharmacy.  .  ad  Edition, 
Revised  and  Enlarged.  437  Illus.  Cloth,  $3.50,-  Sheep,  $4.50 

COBLENTZ.    Volumetric  Analysis.     Illustrated.  In  Press. 

BEASLEY.  Book  of  3100  Prescriptions.  Collected  from  the 
Practice  of  the  Most  Eminent  Physicians  and  Surgeons — English, 
French,  and  American.  A  Compendious  History  ot  the  Materia 
Medica,  Lists  of  the  Doses  of  all  the  Officinal  and  Established  Pre- 
parations, an  Ii»dex  of  Diseases  and  their  Remedies.     7th  Ed.    |2.oo 


MEDICAL   BOOKS.  17 


BEASLEY.  Druggists'  General  Receipt  Book.  Comprising 
a  Copious  Veterinary  Formulary,  Recipes  in  Patent  and  Proprietary 
Medicines,  Druggists'  Nostrums,  etc. ;  Perfumery  and  Cosmetics, 
Beverages,  Dietetic  Articles  and  Condiments,  Trade  Chemicals, 
Scientific  Processes,  and  many  Useful  Tables.     loth  Ed.  |2.oo 

BEASLEY.  Pharmaceutical  Formulary.  A  Synopsis  of  the 
British,  French,  German,  and  United  States  Pharmacopoeias.  Com- 
prising Standard  and  Approved  Formulae  for  the  Preparations  and 
Compounds  Employed  in  Medicine.     T2th  Edition.  ^2.00 

PROCTOR.  Practical  Pharmacy.  3d  Edition,  with  Illustrations 
and  Elaborate  Tables  of  Chemical  Solubilities,  etc.  ^3.00 

ROBINSON.     Latin  Grammar  of  Pharmacy  and   Medicine. 

3d  Edition.     With  elaborate  Vocabularies.  |i-75 

SAYRE.     Organic  Materia  Medica  and  Pharmacognosy.    An 

Introduction  to  the  Study  of  the  Vegetable  Kingdom  and  the  Vege- 
table and  Animal  Drugs.  Comprising  the  Botanical  and  Physical 
Characteristics,  Source,  Constituents,  and  Pharmacopeial  Prepar- 
ations, Insects  Injurious  to  Drugs,  and  Parmacal  Botany.  With 
sections  on  Histology  and  Microtechnique,  by  W.  C.  Stevens. 
374  Illustrations.     Second  Edition.  Cloth,  I4.50 

SCOVILLE.  The  Art  of  Compounding.  Second  Edition,  Re- 
vised and  Enlarged.  Cloth,  $2.50 

STEWART.  Compend  of  Pharmacy.  Based  upon  "  Reming- 
ton's Text-Book  of  Pharmacy."  5th  Edition,  Revised  in  Accord- 
ance with  the  U.  S.  Pharmacopoeia,  1890.  Complete  Tables  of 
Metric  and  English  Weights  and  Measures.     .80;   Interleaved,  $1.00 

TAVERA.     Medicinal  Plants  of  the  Philippines.    Just  Ready. 

^2. 00 

UNITED  STATES  PHARMACOPCEIA.  7th  Decennial  Revision. 
Cloth,  $2.50  (postpaid,  $2.77) ;  Sheep,  $3.00  (postpaid,  I3.27) ;  Inter- 
leaved, $4.00  (postpaid,  $4.50);  Printed  on  one  side  of  page  only, 
unbound,  $3.50  (postpaid,  $3.90). 

Select  Tables  from  the  U.  S.  P.    Being  Nine  of  the  Most  Impor- 
tant and  Useful  Tables,  Printed  on  Separate  Sheets.  .25 

POTTER.  Hand-Book  of  Materia  Medica,  Pharmacy,  and 
Therapeutics.    600  Prescriptions.    8th  Ed.    Clo.,  fc.oo ;  Sh.,  $6.00 


PHYSIOLOGY. 

BIRCH.  Practical  Physiology.  An  Elementary  Class  Book. 
62  Illustrations.  $1.75 

BRUBAKER.  Compend  of  Physiology.  loth  Edition,  Revised 
and  Enlarged.     Illustrated.  .80;  Interleaved,  |i. 00 

JONES.    Outlines  of  Physiology.     96  Illustrations.  ^1.50 

KIRKES.  Handbook  of  Physiology.  17th  Authorized  Edition. 
Revised,  Rearranged,  and  Enlarged.  By  Prop.  W.  D.  Hallibur- 
ton, of  Kings  College,  London.  681  Illustrations,  some  of  which 
are  in  colors.  Cloth,  fo.oo;  Leather,  I3.75 


18  SUBJECT  CATALOGUE. 

LANDOIS.  A  Text-Book  of  Human  Physiology,  Including 
Histology  and  Microscopical  Anatomy,  with  Special  Reference  to 
the  Requirements  of  Practical  Medicine.  5th  American,  translated 
from  the  9th  German  Edition,  with  Additions  by  Wm.  Stirling, 
M.D.,D.sc.    845  Illus.,  many  of  which  are  printed  in  colors.   In  Press. 

STARLING.     Elements  of  Human  Physiology.    100  Ills,    jli.oo 

STIRLING.  Outlines  of  Practical  Physiology.  Including 
Chemical  and  Experimental  Physiology,  with  Special  Reference  to 
Practical  Medicine.    3d  Edition.    289  Illustrations.  ^2.00 

TYSON.    Cell  Doctrine.    Its  History  and  Present  State.        J1.50 


PRACTICE. 

BEALE.    On  Slight  Ailments ;  their  Nature  and  Treatment. 

2d  Edition,  Enlarged  and  Illustrated.  $1.25 

FAGGE.     Practice  of  Medicine.      4th   Edition,  by  P.  H.   Pye- 
Smith,  M.D.     2  Volumes.  In  Press. 

FOWLER.  Dictionary  of  Practical  Medicine.  By  various 
writers.  An  Encyclopsedia  of  Medicine.  Clo.,$3.oo;  Half  Mor.  ^^4.00 
GOULD  AND  PYLE.  Cyclopedia  of  Practical  Medicine  and 
Surgery.  A  Concise  Reference  Handbook,  Alphabetically 
Arranged,  with  particular  Reference  to  Diagnosis  and  Treatment. 
Edited  by  Drs.  Gould  and  Pyle,  Assisted  by  72  Special  Con- 
tributors. Illustrated,  one  volume.  Large  Square  Octavo,  Uniform 
with  "  Gould's  Illustrated  Dictionary." 

Sheep  or  Half  Morocco,  $10.00;  with  Thumb  Index,  $11.00 
Half  Russia,  Thumb  Index,  $12.00 

4GS*  Complete  descriptive  circular  free  upon  application. 

HUGHES.    Compend  of  the  Practice  of  Medicine.    6th  Edition, 
Revised  and  Enlarged. 

Part  I.     Continued,  Eruptive,  and  Periodical  Fevers,  Diseases  of  the 
Stomach,   Intestines,  Peritoneum,  Biliary   Passages,  Liver,  Kid- 
neys, etc.,  and  General  Diseases,  etc. 
Part  II.     Diseases  of  the  Respiratory  System,  Circulatory  System, 
and  Nervous  System;  Diseases  of  the  Blood,  etc. 

Price  of  each  part,  .80;  Interleaved,  $1.00 

Physician's   Edition.      In  one  volume,  including  the  above  two 

parts,  a  Section  on  Skin   Diseases,  and  an  Index.     6th  Revised 

Edition.     625  pp.  Full  Morocco,  Gilt  Edge,  $2.25 

MURRAY.     Rough  Notes  on  Remedies.     4th  Ed.    Just  Ready. 

$1.25 
TAYLOR.  Practice  of  Medicine.  6th  Edition.  Just  Ready.  $4.00 
TYSON.  The  Practice  of  Medicine.  By  Jamks  Tyson,  m.d.. 
Professor  of  Medicine  in  the  University  of  Pennsylvania.  A  Com- 
plete Systematic  Text-book  with  Special  Reference  to  Diagnosis  and 
Treatment.  2d  Edition,  Enlarged  and  Revised.  Colored  Plates  and 
125  other  Illustrations.     1222  Pages.      Cloth,  $5.50  ;  Leather,  $6.50 


PRESCRIPTION  BOOKS. 

BEASLEY.  Book  of  3100  Prescriptions.  Collected  from  the 
Practice  of  the  Most  Eminent  Physicians  and  Surgeons — English, 
French,  and  American.  A  Compendious  History  of  the  Materia, 
Medica,  Lists  of  the  Doses  of  all  Officinal  and  Established  Prepara- 
tions, and  an  Index  of  Diseases  and  their  Remedies.    7th  Ed.    $2.00 


MEDICAL  BOOKS. 


BEASLEY.  Druggists'  General  Receipt  Book.  Comprising 
a  Copious  Veterinary  Formulary,  Recipes  m  Patent  and  Proprie- 
tary Medicines,  Druggists'  Nostrums,  etc.  ;  Perfumery  and  Cos- 
metics, Beverages,  Dietetic  Articles  and  Condiments,  Trade  Chem- 
icals, Scientific  Processes,  and  an  Appendix  of  Useful  Tables, 
loth  Edition,  Revised.  ^2.00 

BEASLEY.  Pocket  Formulary.  A  Synopsis  of  the  British,  French, 
German,  and  United  States  Pharmacopoeias  and  the  chiel  unofficial 
Formularies.     12th  Edition.  $2.00 


SKIN. 

BULKLEY.    The  Skin  in  Health  and  Disease.    Illustrated.    .40 
CROCKER.    Diseases  of  the  Skin.    Their  Description,  Pathol- 
ogy, Diagnosis,  and  Treatment,  with  Special  Reference  to  the  Skin 
Eruptions  of  Children.  92  lUus.   3d  Edition.  Preparing. 

SCHAMBERG.  Diseases  of  the  Skin.  2d  Edition,  Revised  and 
Enlarged.    105  Illustrations.    Being  No.  16  ?Quiz-Compend?  Series. 

Cloth,  .80;  Interleaved,  $1.00 

VAN  HARLINGEN.  On  Skin  Diseases.  A  Practical  Manual 
of  Diagnosis  and  Treatment,  with  special  reference  to  Differential 
Diagnosis.  3d  Edition,  Revised  and  Enlarged.  With  Formulae 
and  60  Illustrations,  some  of  which  are  printed  in  colors.        J2.75 


SURGERY  AND  SURGICAL  DIS- 
EASES (see  also  Urinary  Organs). 

BERRY.  Diseases  of  the  Thyroid  Gland  and  Their  Surgica 
Treatment.     Illustrated.    Just  Ready.  $4.00 

BUTLIN.  Operative  Surgery  of  Malignant  Disease.  2d  Edi- 
tion.    Illustrated.     Octavo.  ^4.50 

DEAVER.  Surgical  Anatomy.  A  Treatise  on  Human  Anatomy 
in  its  Application  to  Medicine  and  Surgery.  With  about  400  very 
Handsome  full-page  Illustrations  Engraved  from  Original  Drawings 
made  by  special  Artists  from  Dissections  prepared  for  the  purpose. 
Three  Volumes.     Royal  Square  Octavo. 

Cloth,  1^21. 00;  Half  Morocco  or  Sheep,  J2 4.00  ;  Half  Russia,  $27.00 
Complete  descriptive  circular  and  special  terms  upon  application. 

DEAVER.  Appendicitis,  Its  Symptoms,  Diagnosis,  Pathol- 
ogy, Treatment,  and  Complications.  Elaborately  Illustrated 
with  Colored  Plates  and  other  Illustrations.     2d  Edition.  l3-5o 

DULLES.  W^hat  to  Do  First  in  Accidents  and  Poisoning. 
5th  Edition.     New  Illustrations.  $1.00 

FULLERTON.     Surgical  Nursing.    3d  Edition.    69  Illus.    Ji.oo 

HAMILTON.    Lectures  on  Tumors.    3d  Edition.  $1.25 

HEATH.  Minor  Surgery  and  Bandaging.  12th  Edition,  Revised 
and  Enlarged.   195  Illus.,  Formulae,  Diet  List,  etc.  Just  Ready.  $1.50 

HEATH.  Injuries  and  Diseases  of  the  Jaws.  4th  Ed.  $4.50 
HORWITZ.  Compend  of  Surgery  and  Bandaging,  including 
Minor  Surgery,  Amputations,  Fractures,  Dislocations,  Surgical  Dis- 
eases, and  the  Latest  Antiseptic  Rules,  etc.,  with  Differential  Diagno- 
sis and  Treatment.  5th  Edition,  very  much  Enlarged  and  Rear- 
ranged.   167  Illustrations,  98  Formulae.   Clo.,  .80 ;  Interleaved,  $1.00 


SUBJECT  CATALOGUE. 


JACOBSON.    Operations    of    Surgery.    Over  aoo  Illustrations. 

Cloth,  $3.00 ;  Leather,  $4.00 

KEHR.  Gall-stone  Disease.  Translated  by  William  Wotkyns 
Seymour,  m.d.  J2.50 

LANE.    Surgery  of  the  Head  and  Neck,     no  IIlus.  $5.00 

MACREADY.  A  Treatise  on  Ruptures.  24  Full-page  Litho- 
graphed Plates  and  Numerous  Wood  Engravings.  Cloth,  $6.00 

MAKINS.  Surgical  Experiences  in  South  Africa.  1899-1900 
Illustrated.  $4.00 

MAYLARD.  Surgery  of  the  Alimentary  Canal.  97  Illustrations. 
2d  Edition,  Revised.  $300 

MOULLIN.  Text-Book  of  Surgery.  With  Special  Reference  to 
Treatment.  3d  American  Edition.  Revised  and  edited  by  John  B. 
Hamilton,  m.d.,  ll.d..  Professor  of  the  Principles  of  Surgery  and 
Clinical  Surgery,  Rush  Medical  College,  Chicago.  623  Illustrations, 
many  of  which  are  printed  in  colors.     Cloth,  ^6.00;  Leather,  >7.oo 

SMITH.  Abdominal  Surgery.  Being  a  Systematic  Description  of 
all  the  Principal  Operations.    224  Illus.  6th  Ed.    2  Vols.  Clo.,  |io.oo 

VOSWINKEL.  Surgical  Nursing.  Second  Edition,  Revised  and 
Enlarged,     in  Illustrations.  |i.oo 

WALSHAM.  Manual  of  Practical  Surgery.  7th  Ed.,  Re- 
vised and  Enlarged.   483  Engravings.   950  pages.  $3.50 

TEMPERATURE  CHARTS,  ETC. 

GRIFFITH.  Graphic  Clinical  Chart  for  Recording  Temper- 
ature, Respiration,  Pulse,  Day  of  Disease,  Date,  Age,  Sex, 
Occupation,  Name,  etc.  Printed  in  three  colors.  Sample  copies 
free.  Put  up  in  loose  packages  of  fifty,. 50.  Price  to  Hospitals,  500 
copies,  ^4.00 ;  1000  copies,  $7.50.  With  name  of  Hospital  printed 
on,  50  cts.  extra. 

KEEN'S  CLINICAL  CHARTS.  Seven  Outline  Drawings  of  the 
Body,  on  which  may  be  marked  the  Course  of  Disease,  Fractures, 
Operations,  etc.  Each  Drawing  may  be  had  separately,  twenty-five 
to  pad,  25  cents. 

SCHREINER.  Diet  Lists.  Arranged  in  the  form  of  a  chart. 
With  Pamphlets  of  Specimen  Dietaries.    Pads  of  50.  .75 

THROAT  AND   NOSE  (see  also  Ear). 

COHEN.    The  Throat  and  Voice.     Illustrated.  .40 

HALL.  Diseases  of  the  Nose  and  Throat.  2d  Edition,  Enlarged. 
Two  Colored  Plates  and  80  Illustrations.  I2.75 

HOLLOPETER.     Hay  Fever.     Its  Successful  Treatment.      $1.00 

KNIGHT.  Diseases  of  the  Throat.  A  Manual  for  Students. 
Illustrated.  Nearly  Ready. 

LAKE.  Laryngeal  Phthisis,  or  Consumption  of  the  Throat. 
Colored  Illustrations.  $2  00 

MACKENZIE.  Pharmacopoeia  of  the  London  Hospital  for 
Dis.  of  the  Throat.    5th  Ed.,  Revised  by  Dr.  F.  G.  Harvey.  $1.00 

McBRIDE.  Diseases  of  the  Throat,  Nose,  and  Ear.  With  col- 
ored Illustrations  from  original  drawings.   3d  Edition.  J7.00 

POTTER.  Speech  and  its  Defects.  Considered  Physiologically, 
Pathologically,  and  Remedially.  |i.oo 

SHEILD.     Nasal  Obstructions.    Illustrated.  ^1.50 

URINE  AND  URINARY  ORGANS. 

ACTON.  The  Functions  and  Disorders  of  the  Reproductive 
Organs  in  Childhood,  Youth,  Adult  Age,  and  Advanced  Life, 
Considered  in  their  Physiological,  Social,  and  Moral  Relations. 
8th  Edition.  ^1.75 


MEDICAL  BOOKS.  21 


BEALE.  One  Hundred  Urinary  Deposits.  On  eight  sheets, 
for  the  Hospital,  Laboratory,  or  Surgery.  Paper,  $2.00 

HOLLAND.  The  Urine,  the  Gastric  Contents,  the  Common 
Poisons,  and  the  Milk.  Memoranda,  Chemical  and  Microscopi- 
cal, for  Laboratory  Use.  Illustrated  and  Interleaved.    6th  Ed.    $1.00 

KLEEN.    Diabetes  and  Glycosuria.  I2.50 

MEMMINGER.    Diagnosis  by  the  Urine.  2d  Ed.  24  Illus.  $1.00 

MORRIS.  Renal  Surgery,  with  Special  Reference  to  Stone  in  the 
Kidney  and  Ureter  and  to  the  Surgical  Treatment  of  Calculous 
Anuria.     Illustrated.  ^2.00. 

MOULLIN.  Enlargement  of  the  Prostate.  Its  Treatment  and 
Radical  Cure.     2d  Edition.     Illustrated.  $1.75 

MOULLIN.  Inflammation  of  the  Bladder  and  Urinary  Fever. 
Octavo.  |i-5o 

SCOTT.  The  Urine.  Its  Clinical  and  Microscopical  Examination. 
41  Lithographic  Plates  and  other  Illustrations.    Quarto.  Cloth,  J5.00 

TYSON.  Guide  to  Examination  of  the  Urine.  For  the  Use  of 
Physicians  and  Students.  With  Colored  Plate  and  Numerous  Illus- 
trations engraved  on  wood.    9th  Edition,  Revised.  >i-25 

VAN  NUYS.    Chemical  Analysis  of  Urine.    39  Illus.         $1.00 


VENEREAL  DISEASES. 

GO\VERS.    Syphilis  and  the  Nervous  System.  $1.00 

STURGIS  AND  CABOT.      Student's    Manual    of  Venereal 

Diseases.     7th  Revised  and  Enlarged  Ed.     i2mo.  $^-^5 


VETERINARY. 

BALLOU.    Veterinary  Anatomy  and  Physiology.    29  Graphic 
Illustrations.  .80;  Interleaved,  jSi. 00 


WOMEN,  DISEASES  OF. 

BISHOP.     Uterine  Fibromyomata.   Their  Pathology,  Diagnosis, 
and  Treatment.     Illustrated.  Cloth,  fe.50 

BYFORD   (H.  T.).     Manual   of  Gynecology.    Second  Edition, 
Revised  and  Enlarged  by  100  pages.     341  Illustrations.  tS-oo 

DUHRSSEN.     A  Manual    of  Gynecological    Practice.     105 
Illustrations.  $^'5° 

FULLERTON.     Surgical  Nursing.     3d  Edition,  Revised  and 
Enlarged.    69  Illustrations.  ^i.oo 

LEWERS.    Diseases  of  Women.    146  Illus.    5th  Ed.  I2.50 

MONTGOMERY.     Practical    Gynecology.     A  Complete  Sys- 
tematic Text-Book.    527  Illustrations.     Cloth,  $5.00;  Leather,  $6.00 

ROBERTS.      Gynecological    Pathology.      With   127   Full-page 
Plates  containing  151  Figures.    Just  Ready.  ii6.oo 

WELLS.    Compend  of  Gynecology.    Illustrated.    2d  Edition. 

.80;  Interleaved,  |i. 00 


22  SUBJECT  CATALOGUE. 


COMPENDS. 


JFVow*  The  Southern  Clinic. 

"  We  know  of  lio  series  of  books  issued  by  any  house  that  so  fully 
meets  our  approval  as  these  ?Quiz-Compends?.  They  are  well  ar- 
ranged, full,  and  concise,  and  are  really  the  best  line  of  text-books  that 
could  be  found  for  either  student  or  practitioner." 


BLAKISTON'S  ?QUIZ-COMPENDS? 

The  Best  Series  of  Manuals  for  the  Use  of  Students. 
Price  of  each,  Cloth,  .80.         Interleaved,  for  taking  Notes,  $1.00. 

49*  These  Compends  are  based  on  the  most  popular  text-books 
and  the  lectures  of  prominent  professors,  and  are  kept  constantly  re- 
vised, so  that  they  may  thoroughly  represent  the  present  state  of  the 
subjects  upon  which  they  treat. 

4S^  The  authors  have  had  large  experience  as  Quiz-Masters  and 
attaches  of  colleges,  and  are  well  acquainted  with  the  wants  of  students. 

4^  They  are  arranged  in  the  most  approved  .form,  thorough  and 
concise,  containing  over  6oo  fine  illustrations,  inserted  wherever  they 
could  be  used  to  advantage. 

JtS"  Can  be  used  by  students  of  any  college. 

4^  They  contain  information  nowhere  else  collected  in  such  a 
condensed,  practical  shape.     Illustrated  Circular  free. 

No.  I.  POTTER.  HUMAN  ANATOMY.  Sixth  Revised  and 
Enlarged  Edition.  Including  Visceral  Anatomy.  Can  be  used 
with  either  Morris's  or  Gray's  Anatomy.  117  Illustrations  and  16 
Lithographic  Plates  of  Nerves  and  Arteries,  with  Explanatory 
Tables,  etc.  By  Samuel  O.  L.  Pottbr,  m.d..  Professor  of  the 
Practice  of  Medicine,  College  of  Physicians  and  Surgeons,  San 
Francisco  ;  Brigade  Surgeon,  U.  S.  Vol. 

No.  2.  HUGHES.  PRACTICE  OF  MEDICINE.  Part  I.  Sixth 
Edition,  Enlarged  and  Improved.  By  Daniel  E.  Hughes,  m.d., 
Physician-in-Chief,  Philadelphia  Hospital,  late  Demonstrator  of 
Clinical  Medicine,  Jefferson  Medical  College,  Phila. 

No.  3.  HUGHES.  PRACTICE  OF  MEDICINE.  Part  II. 
Sixth  Edition,  Revised  and  Improved.     Same  author  as  No.  2. 

No.  4.  BRUBAKER.  PHYSIOLOGY.  Tenth  Edition,  with 
Illustrations  and  a  table  of  Physiological  Constants.  Enlarged 
and  Revised.  By  A.  P.  Brubaker,  m.d..  Professor  of  Physiology 
and  General  Pathology  in  the  Pennsylvania  College  of  Dental 
Surgery;  Adjunct  Professor  of  Physiology,  Jefferson  Medical 
College,  Philadelphia,  etc. 

No.  5.  LANDIS.  OBSTETRICS.  Seventh  Edition.  By  Henry  G. 
Landis,  m.d.  Revised  and  Edited  by  Wm.  H.  Wells,  m.d.. 
Demonstrator  of  Clinical  Obstetrics,  Jefferson  Medical  College, 
Philadelphia.     Enlarged.     52  Illustrations. 

No.  6.  POTTER.  MATERIA  MEDICA,  THERAPEUTICS, 
AND  PRESCRIPTION  WRITING.  Sixth  Revised  Edition 
(U.  S.  P.  1890).  By  Samuel  O.  L.  Pottbr,  m.d..  Professor  of 
Practice,  College  of  Physicians  and  Surgeons,  San  Francisco; 
Brigade  Surgeon,  U.  S.  Vol. 


MEDICAL  BOOKS.  23 


?  QUIZ-COMPENDS  ?— Continued. 

No.  7.  WELLS.  GYNECOLOGY.  Second  Edition.  ByWM.  H. 
Wells,  m.d.,  Demonstrator  of  Clinical  Obstetrics,  JeflFersoD 
Medical  College,  Philadelphia.     140  Illustrations. 

No.  8.  GOULD  AND  PYLE.  DISEASES  OF  THE  EYE 
AND  REFRACTION.  Second  Edition.  Including  Treatment 
and  Surgery,  and  a  Section  on  Local  Therapeutics.  By  Gkorgk 
M.  Gould,  m.d.,  and  W.  L.  Pyle,  m.d.  With  Formulae,  Glossary 
Tables,  and  109  Illustrations,  several  of  which  are  Colored. 

No.  9.  HORWITZ.  SURGERY,  Minor  Surgery,  and  Bandag- 
ing. Fifth  Edition,  Enlarged  and  Improved.  By  Orvillb 
HoRWiTZ,  B.  s.,  M.D.,Clinical  Professor  of  Genito-Urinary  Surgery 
and  Venereal  Diseases  in  Jeflferson  Medical  College  ;  Surgeon  to 
Philadelphia  Hospital,  etc.   With  98  Formulae  and  71  Illustrations. 

No.  10.  LEFFMANN.     MEDICAL    CHEMISTRY.      Fourth 

Edition.  Including  Urinalysis,  Animal  Chemistry,  Chemistry  of 
Milk,  Blood,  Tissues,  the  Secretions,  etc.  By  Henry  Lbffmann, 
m.d.,  Professor  of  Chemistry  in  the  Woman's  Medical  College  of 
Penna ;  Pathological  Chemist,  Jefferson  Medical  College  Hospital. 
No.  II.  STEWART.  PHARMACY.  Fifth  Edition.  Based  upon 
Prof.  Remington's  Text-Book  of  Pharmacy.  By  F.  E.  Stewart, 
M.D.,  PH. G., late  Quiz-Master  in  Pharmacy  and  Chemistry,  Phila- 
delphia College  of  Pharmacy ;  Lecturer  at  Jeflferson  Medical 
CoUege.     Carefully  revised  in  accordance  with  the  new  U.  S.  P. 

No.  12.  BALLOU.  VETERINARY  ANATOMY  AND  PHY- 
SIOLOGY. Illustrated.  By  Wm.  R.  Ballou,  m.d..  Professor 
of  Equine  Anatomy  at  New  York  College  of  Veterinary  Surgeons  ; 
Physician  to  Bellevue  Dispensary,  etc.     29  graphic  Illustrations 

No.  13.  WARREN.  DENTAL  PATHOLOGY  AND  DEN- 
TAL MEDICINE.  Third  Edition,  Illustrated.  Containing 
a  Section  on  Emergencies.  By  Geo.  W.  Warren,  d.d.s..  Chief 
of  Clinical  Staff,  Pennsylvania  College  of  Dental  Surgery. 

No.  i^.  HATFIELD.  DISEASES  OF  CHILDREN.  Second 
Edition.  Colored  Plate.  By  Marcus  P.  Hatfield,  Profes- 
sor of  Diseases  of  Children,  Chicago  Medical  College. 

No.  15.  THAYER.   GENERAL  PATHOLOGY.  By  A.  E. 

Thayer,  m.d.,  Cornell  University  Medical  College.    Illustrated. 

No.  i6.  SCHAMBERG.  DISEASES  OF  THE  SKIN.  Second 
Edition.  By  Jay  F.  Schambhrg,  m.d..  Professor  of  Diseases  of 
the  Skin,  Philadelphia  PolycUnic.  Second  Edition,  Revised  and 
Enlarged.     105  handsome  Illustrations. 

No.  17.  GUSHING.  HISTOLOGY.  By  H.  H,  Gushing,  m.d.. 
Demonstrator  of  Histology,  Jefferson  Medical  College,  Philadel- 
phia.    Illustrated. 

No.  18.  THAYER.  SPECIAL  PATHOLOGY.  Illustrated.  By 
same  Author  as  No.  15. 

Price,  each,  Cloth,  .80.  Interleaved,  for  taking  Notes,  $1.00. 

Careful  attention  has  been  given  to  the  construction  of  each  sentence, 
and  while  the  books  will  be  found  to  contain  an  immense  amount  of 
knowledge  in  small  space,  they  will  likewise  be  found  easy  reading ; 
there  is  no  stilted  repetition  of  words ;  the  style  is  clear,  lucid,  and  dis- 
tinct. The  arrangement  of  subjects  is  systematic  and  thorough ;  there 
is  a  reason  for  every  word.    They  contain  over  600  illustrations. 


THE  STANDARD  TEXT-BOOK 

Morris^  Anatomy 

SECOND  EDITION 

Rewritten.    Revised.    Improved 

WITH  MANY  NEW  ILLUSTRATIONS 


Has  been  recommended  as  a  text-book  at  more  than 
seventy  of  the  most  prominent  medical  schools  in  the  United 
States  and  Canada,  and  is  considered  by  all  anatomists  as  a 
standard  authority.  It  contains  many  features  of  special 
advantage  to  students.  A  complete  Text-book.  Edited  by 
Henry  Morris,  f.r.c.s.,  Surgeon  to,  and  Lecturer  on 
Anatomy  at,  Middlesex  Hospital,  assisted  by  J.  BlaniJ 
Sutton,  f.r.c.s.,  J.  H.  Davies-Colley,  f.r.c.s.,  Wm.  J. 
Walsham,  f.r.c.s.,  H.  St.  John  Brooks,  m.d.,  R.  Mar- 
cus GuNN,  f.r.c.s.,  Arthur  Hensman,  f.r.c.s.,  Fred- 
erick Treves,  f.r.c.s.,  William  Anderson,  f.r.c.s., 
Prof.W.  H.  a.  Jacobson,  and  Arthur  Robinson,  m.r.c.s. 

Octavo.    With  790  Illustrations,  of  which  a  large  number 
are  printed  in  colors 

CLOTH.  $6.00;    LEATHER.  $7.00 


**  The  ever-growing  popularity  of  the  book  with  teach- 
ers and  students  is  an  index  of  its  value,  and  it  may  safely 
be  recommended  to  all  interested." — From  7'he  Medical 
Record,  New  York. 

"Of  all  the  text-books  of  moderate  size  on  human 
anatomy  in  the  English  language,  Morris  is  undoubtedly 
the  most  up-to-date  and  accurate." — From  The  Philadel- 
phia Medical  Journal. 

THUMB  INDEX  IN  EACH  COPY 


Eighth  Revised  Edition* 


POTTER'S  MATERIA  MEDICA,  PHARMACY,  AND 
THERAPEUTICS.  Eighth  Edition,  Enlarged  and 
Revised*  A  Handbook,  including  the  Physiological 
Action  of  Drugs,  Special  Therapeutics  of  Disease,  Official 
and  Practical  Pharmacy,  Prescription  Writing,  etc.  By 
Samuel  O.  L.  Potter,  m.a.,  m.d.,  formerly  Professor  of 
the  Practice  of  Medicine,  Cooper  Medical  College,  San 
Francisco;  late  Major  and  Brigade  Surgeon,  U.  S.  Vol., 
etc.      Octavo.      950  pages.     Thumb  Index. 

Cloth,  net,  ^5.00;   Leather,  net,  %(>.oq 


A  UNIQUE  BOOK. 


The  present  edition  contains  material  gathered  from  the  writer's  experience  in 
active  professional  practice  in  a  tropical  climate,  among  soldiers  and  civilians,  men, 
women,  and  children,  during  a  period  of  nearly  two  years'  duration. 

The  text  throughout  the  book  has  again  been  subjected  to  a  thorough  and  critical 
revision,  has  been  largely  rewritten,  and  has  been  expanded  by  the  introduction  of 
much  new  matter.  The  latter  has  to  some  extent  taken  the  place  of  material  consid- 
ered obsolete  or  comparatively  unimportant,  so  that  the  increased  size  of  the  book 
over  the  previous  edition  is  only  twenty  pages. 

In  the  section  on  Materia  Medica  twelve  articles  have  been  rewritten  and 
thirty-eight  new  articles  have  been  inserted.  The  rewritten  ones  are  those  on  Argen- 
tum,  Cinchona,  Coca,  Coffea,  Digitalis,  Dulcin,  Ergot,  Ferrum,  Ipecacuanha,  Myrrha, 
Saccharinum,  and  Veratrum  Viride.  The  new  matter  includes  paragraphs  on  Actol, 
Airol,  Argentamin.Argentol,  Argonin,Chinosol,  Creosotal,  Dionine,  Eucaine,  Eudoxin, 
Glycero-phosphates,  Heroine,  Holocaine,  lodothyrin,  Itrol,  Largin,  Nosophen,  Orphol, 
Orthoform,  Passiflora,  Pellotine,  Peronine,  Phloridzin,  Piperidin,  Protargol,  Tuber- 
culin-R,  Urotropin,  and  Xeroform. 

In  the  section  on  Therapeutics  new  articles  are  inserted  on  Local  Anesthesia, 
Beriberi,  Dhobie  Itch,  Tropical  Fevers,  Heat-stroke,  Hemoglobinuric  Fever,  Lymph- 
adenoma,  Miliaria,  Bubonic  Plague,  Sprue,  Tinea  Imbricata,  Tinea  Versicolor,  and 
Toxemia.  Twenty-eight  articles  in  this  portion  of  the  book  have  been  rewritten, 
including  those  on  Amenorrhea,  Asthma,  Boils,  Cholera,  Diabetes,  Dysentery,  Dysp- 
nea, Gonorrhea,  Insomnia,  Leprosy,  Lucocythemia,  Lichen,  Myxedema,  Pemphigus, 
Phthisis,  Remittent  Fever,  Typhoid  Fever,  Septicemia,  Shock,  Suppuration,  Ulcers, 
Uremia,  Variola,  and  Wounds.  The  text  of  many  other  articles  has  been  expanded 
by  the  incorporation  of  more  than  two  hundred  items  from  current  medical  literature 
and  from  the  author's  personal  experience  in  practice. 

Arrangement  of  Contents. 

Introduction. — Administration  of  Drugs,  Classification,  Dosage,  etc. 

Part  I. — Materia  Medica  and  Therapeutics,  arranged  alphabetically  ;  under  each 
drug  is  given  its  Synonym,  Description,  Preparations,  Analogous  Compounds,  Deriva- 
tives, and  Doses,  official  and  unofficial ;  Physiological  Action ;  Antagonists,  Anti- 
dotes ;  Therapeutics. 

Part  II.— Pharmacy  and  Prescription  Writing ;  Constituents  of  Vegetable  Drugs ; 
Weights  and  Measures  ;  Incompatibility;  Extemporaneous  Pharmacy,  etc.  Written 
for  the  physician  who  prefers  to,  or  must  from  necessity,  dispense  his  own  medicines. 

Part  III. — Special  Therapeutics.  Consists  of  280  pages,  in  which  diseases  are 
taken  up  in  alphabetical  order  and  the  treatment  indicated  in  each  concisely  stated. 
This  section  contains  a  vast  number  of  suggestions  and  over  650  Prescriptions,  For- 
mulae, etc. 

Appendix,  containing  many  useful  Tables  of  Differential  Diagnosis,  Lists  of 
Latin  Phrases,  Hyperdermic  and  Patent  Medicine  Formulae,  etc. 

Index,  38  pages,  double  column,  very  carefully  prepared. 


FOR  MEDICAL  STUDENTS. 

TAYLOR  AND  WELLS.     DISEASES  OF,  CHILDREN.     Illus- 


THE  LIBRARY 

UNIVERISTY  OF  CALIFORNIA,  SAN  FRANCISCO 

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THIS  BOOK  IS  DUE  ON  THE  LAST  DATE  STAMPED  BELOW 

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consult  Lending  Code. 


28  DAY 

M  2  2  1995 

RETURNEd 
AUG  3  0  1995 


Series  4128 


P.  BLAKISTON'S  SON   &.  CO.,  Publishers  and  Booksellers, 

1012    WALNUT   STREET,    PHILADELPHIA. 


FOR  MEDICAL  STUDENTS. 


KIRKES'  PHYSIOLOGY.  Seventeenth  Edition.  {The  Authorized 
Edition.  i2?no.  Dark  Red  Cloth.)  Revised  and  Enlarged.  By  W. 
D.  Halliburton,  m.d.,  f.r.s.,  Professor  of  Physiology,  King's  College, 
London.     68i    Illustrations,  a  number  of  which  are  printed  in  Colors. 

Cloth,  net^  ^3.00 

STOHR.  TEXT-BOOK  OF  HISTOLOGY,  INCLUDING  THE 
MICROSCOPICAL  TECHNIC.  By  Dr.  Philip  Stohr,  Professor 
of  Anatomy  at  University  of  Wiirzburg.  Authorized  Translation.  Edited, 
wiUi  Additions,  hv  Dr.  AlF£.1<1D  Schapf.R.  Profejisor  _£if_  Anainmy,  Uni- 

Ql!28     Potter,   S.O,  L.  85937       "tflt 


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